肝细胞癌患者多药耐药蛋白及信使核糖核酸表达与99mTc-甲氧基异丁基异腈（MIBI）显像的相关性
Correlation of expression of multidrug resistance protein and messenger RNA with 99mTc-methoxyisobutyl isonitrile (MIBI) imaging in patients with hepatocellular carcinoma.
作者信息
Wang Hai, Chen Xiao-Ping, Qiu Fa-Zu
机构信息
Hepatic Surgery Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
出版信息
World J Gastroenterol. 2004 May 1;10(9):1281-5. doi: 10.3748/wjg.v10.i9.1281.
AIM
To explore whether P-glycoprotein (Pgp) and other pumps, multidrug resistance-associated protein (MRP) and lung resistance protein (LRP), could affect tumor accumulation and efflux of 99mTc-MIBI in liver cancer.
METHODS
Surgically treated 78 liver cancer patients were included in this study. Before surgery, 99mTc-MIBI SPECT was performed 15 min and 120 min after injection of 20 mCi 99mTc-MIBI, respectively. Early uptake, delayed uptake (L/Nd), and washout rate (L/Nwr) of 99mTc-MIBI were obtained. Expressions of Pgp, MRP and LRP were investigated with Western blotting and immunohistochemistry. Messenger RNA (mRNA) level of Pgp, MRP and LRP was determined by RT-PCR.
RESULTS
No 99mTc-MIBI uptakes in tumor lesions of 68 of 78 (87.2%) patients with hepatocellular carcinoma were found on 99mTc-MIBI SPECT. P-gp expression was observed in tumor tissues of the patients with no uptake of 99mTc-MIBI (P<0.017). No appreciable correlation was found between liver cancer 99mTc-MIBI images and expression of MRP or LRP on the level of protein or mRNA.
CONCLUSION
99mTc-MIBI SPECT is noninvasive, and useful in predicting the presence of MDR1 gene-encoded Pgp in patients with hepatocellular carcinoma.
目的
探讨P-糖蛋白（Pgp）及其他转运蛋白，多药耐药相关蛋白（MRP）和肺耐药蛋白（LRP）是否会影响99mTc-MIBI在肝癌中的肿瘤摄取及流出。
方法
本研究纳入78例接受手术治疗的肝癌患者。手术前，分别于注射20mCi 99mTc-MIBI后15分钟和120分钟进行99mTc-MIBI SPECT检查。获得99mTc-MIBI的早期摄取、延迟摄取（L/Nd）和洗脱率（L/Nwr）。采用蛋白质印迹法和免疫组织化学法研究Pgp、MRP和LRP的表达。通过RT-PCR测定Pgp、MRP和LRP的信使核糖核酸（mRNA）水平。
结果
78例肝细胞癌患者中，68例（87.2%）患者的肿瘤病灶在99mTc-MIBI SPECT上未发现99mTc-MIBI摄取。在99mTc-MIBI未摄取患者的肿瘤组织中观察到P-gp表达（P<0.017）。在蛋白质或mRNA水平上，未发现肝癌99mTc-MIBI图像与MRP或LRP表达之间存在明显相关性。
结论
99mTc-MIBI SPECT具有无创性，可用于预测肝细胞癌患者中MDR1基因编码的Pgp的存在。
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