Clinical Significance Of Expression Of BCRP,P-gp,LRP And Akt In Primary And Recurrent Epithelial Ovarian Carcinoma

Objective: To investigate the expressions of BCRP,P-gp,LRP and Akt using immunohistochemical analysis in primary and recurrent ovarian carcinoma of the same patient. It would reveal multidrug resistance by researching the signs of cancer stem cells and expression of resistant protein. Valuable signs would be offered for predictly judging chemotherapic effect and choosing effective chemotherapentics. It deepen understanding the recurrent mechanism and provide new clue for therapy of ovarian cancer.Methods:1 Patients and Groups: Selecting 30 patients cases with the human epithelial ovarian cancer from the Fourth Hospital of Hebei Medical University who had been received surgery to treat for twice. And consistent with next conditions:â‘ Before primary operation did not receive chemotherapyâ‘¡histology final diagnosisâ‘¢After the primary operation gave them the union chemotherapy more than six coursesâ‘£After recurrence of the cases gave them all the second operation and obtained the twice tissue samples of cancers of the same cases. According to the standard made by WHO: There were 19 middle and 11 low differentiations in the primary tissues and 11 middle and 19 low differentiations in the recurrent tissues.2 Methods: After specimen got,make continuous slices of 4 micrometers with microtome. Glass-slides are made into tissue slices after dealed with L-polylysine,then specimen are dyed with BCRP,P-gp,LRP and Akt antibodies,reading with microscope. Select 10 high diploid visual.3 Statistical analysis: According to statistics data processing fields,take count of the number of the sum of the tumor cells and positively dyed cells,and then get the percentage of positive cells. Principle,all data should be checked by X2 test and Fisher precise probability. Spearman analyzed the correlation of two signs. It has statistics significance by P<0.05.Results:1 The ratios of BCRP,P-gp,LRP and Akt expression in recurrent tissues were much higher than in primary tissues (P<0.05), showed significant difference. But the overexpression ratios of P-gp,LRP and Akt in recurrent tissues showed no significant difference to the primary tissues (P>0.05). The overexpression ratio of BCRP expression in recurrent tissues higher than in primary tissues(P<0.05),showed significant difference.2 In 30 ovarian cancers,there were 11 low differentiations in primary tissues and 19 low differentiations in recurrent tissues. Eight patients turned from middle to low differentiation,the turned ratio was 42.1%.Low differentiation cancers in the recurrent tissues was more than the low differentiation cancers in the primary tissues(P<0.05),showed significant difference.3 In the recurrent ovarian cancers, the ratios of P-gp,LRP and Akt expression and overexpression in low differentiation cancers showed no significant difference to that in moderate and high differentiation cancers. But the ratio of BCRP expression and overexpression in low differentiation cancers higher than that in moderate and high differentiation cancers(P<0.05), showed significant difference.4 In the recurrent ovarian cancers,the chemotherapic efficiency rates for BCRP,P-gp,LRP and Akt negative were higher than the chemotherapic efficiency rates for BCRP,P-gp,LRP and Akt positive (P<0.05), showed significant difference.5 The expression of BCRP with P-gp,LRP and Akt assumed positive correlation in the recurrent ovarian carcers.Conclusions:1 BCRP could play a more important role. Overexpressed BCRP have obviously correlation with the recurrent of ovarian cancers. P-gp,LRP and Akt could contribute to the obtainal drug resistance induced by chemotherapy.2 Analyzed the clinical material prompted that the recurrent course of ovarian had significant relationship with the transformation of differentiation from high to low.3 BCRP had relationship with the differentiation. But P-gp,LRP and Akt had no relation with the differentiation of patients,That showed BCRP could hold the cells to no and low differentiation status. Cancer Stem Cells highly expressed BCRP inferred that BCRP could control the differentiation of the stem cells. So we presume:BCRP could pump the chemotherapeutics and correlation factor of differentiation out of cells. Resulted in a few of no and low differention status cancer stem cells alive after recurrence.4 The expression of resistance gene BCRP,P-gp,LRP and Akt have correlation with poor chemotherapic effect. They can good judge the chemotherapic effect and the expression of them have a highly predictive value for drug resistance.5 The expression of BCRP with P-gp,LRP and Akt assumed positive correlation in the recurrent ovarian cancers. It indicate that BCRP with P-gp,LRP and Akt have effect of congenerous expression.