LRP、Bcl-2在骨肉瘤组织中的表达对化疗耐药的预测价值

目的：探讨肺耐药蛋白(LRP)，B淋巴细胞瘤／白血病—2(bcl—2)在骨肉瘤组织中的表达，评估其对骨肉瘤耐药的预测价值。方法：用免疫组织化学方法检测了42例石蜡包埋的骨肉瘤组织和16例正常骨组织中LRP、bcl—2的表达。结果：42例骨肉瘤中LRP、bcl—2的表达率分别为42．86％(18／42)、52．38％(22／42)。这两种指标的表达无相关性(P＞0．05)，但两者可协同表达;LRP和bcl—2的表达在不同的年龄组、性别、分型及Enneking分期中均无显著性差异(P＞0．05)。对27例患者进行化疗评价,LRP阳性组与阴性组对化疗的反应率为14．3％(1／7)及55．0％(11／20)，两组比较，有极显著性差异(P＜0．01)；LRP阳性对耐药的预测值为85．7％，LRP阴性对耐药的预测值为55．0％。bcl—2阳性组与阴性组对化疗的反应率为13．3％(2／15)及83．3％(10／12)，两组比较，有显著性差异(P＜0．05)；bcl—2阳性对耐药的预测值为86．7％，bcl—2阴性对耐药的预测值为55．0％。结论：LRP和bcl—2等多因素联合作用是骨肉瘤多药耐药性的主要作用机制，联合检测LRP和bcl—2能较好地预测骨肉瘤化疗反应及耐药。

VALUE OF EXPRESSION OF LRP AND BCL-2 IN OSTEOSARCOMA AS PREDICTOR OF CHEMORESISTANCE

Objective:to evaluate the value of lung resistance protein(LRP) and B lymphoma/leukemia 2(bcl 2) as predictors of resistance to chemotherapy in osteosarcomas.Methods:expression of LRP and bcl 2 was immunohistochemically studied in paraffin sections from 16 normal bone tissues and 42 specimens of osteosarcoma from patients who had not received any chemotherapy before surgery.Results:There was no detectable LRP or bcl 2 expression in 16 normal bone tissues.The positive expression rates of LRP and bcl 2 were 42 86%(18/42) and 52 38%(22/42) respectively and showed no significant correlation( P >0 05).Expression of LRP and bcl 2 had no relation with age,sex,histologic type and clinical stage( P >0 05).Evaluation for 27 osteosarcoma patients showed that difference in the response rates between the two groups was significant ( P <0 05).The predictive value of positive LRP stain for drug resistance was 85 7%(6/7),and that of negative stain was 55 0%(11/20).The response rate to chemotherapy of the bcl 2 positive group 13 3%(2/15)] was significantly lower than that of the LRP negative group83 3%(10/12), P <0 01].The predictive value of positive bcl 2 stain for drug resistance was 86 7%(13/15) and that of negative stain was 55 0%.Conclusion:Detecting expression of LRP and bcl 2 may play an important role in judging drug resistence of human osteosarcoma.