摘 要 目的：探讨增殖细胞相关核抗原Ki-67和肺耐药蛋白(lung resistance protein,LRP)在各乳腺癌亚型中的表达及其临床意义。方法：选取新疆医科大学附属肿瘤医院2009年1月至2009年10月间经手术切除的203例乳腺癌患者癌组织标本，免疫组织化学法检测癌组织中ER、PR、HER2、Ki-67和LRP蛋白的表达情况，比较Ki-67及LRP在各乳腺癌亚型中表达的差异，并分析其与乳腺癌临床病理特征的相关性。结果：通过基因表达检测确定的4种乳腺癌亚型(Luminal A型、Luminal B型、基底样型和HER2过表达型)在临床病理特征中除了在组织学分型（小叶癌和导管癌）没有差异外，在肿瘤的大小、临床分期、淋巴结转移、组织分级及患者的年龄分布等方面均存在差异（P<0.05）。与其他3种亚型相比Ki-67及LRP在Luminal B型乳腺癌（ER/PR+，HER2+）中高表达（93.2%，86.2%，P<0.05），LRP与Ki-67表达无相关性（r=0.144，P>0.05）。Luminal B型乳腺癌中LRP阳性表达组患者的化疗有效率（39.4%）低于阴性表达组（83.3%，P<0.05)；而Ki-67表达阳性与阴性组患者的化疗有效率分别为44.4%、66.7%，差异无统计学差异（P>0.05）。结论：Ki-67、LRP在各乳腺癌亚型中表达存在差异，Luminal B型乳腺癌中LRP的高表达与术后化疗的疗效存在相关性。

Abstract Objective:To investigate the expressions of Ki-67 and LRP in different breast cancer subtypes and the relevant clinical significance. Methods: Breast cancer specimens were collected from 203 patients who underwent operation in the Affiliated Tumor Hospital of Xinjiang Medical University during Jan. to Oct. 2009. The expression of ER, PR, HER2, Ki-67 and LRP in the breast cancer tissues was determined by immunohistochemical staining. Ki-67 and LRP expression and its correlation with clinical and pathological features of different breast cancer subtypes was analyzed. Results: Four breast cancer subtypes were identified with different ER, PR and HER2 gene expression patterns. There were significant differences in tumor sizes, clinical stages, histological grades, lymph node metastases, and patient’ ages between the 4 breast cancer subtypes(P<0.05), but not in cancer type. Ki-67 and LRP proteins were highly expressed in Luminal B(ER/PR+, HER2+) breast cancer(93.2%, 86.2%, P<0.05), but the expression of the two was not correlated with each other(r=0.144, P>0.05). The chemotherapy efficiency for LRP-positive Luminal B patients was lower than that in LRP-negative Luminal B patients(39.4% vs 83.3%, P<0.05), while the chemotherapy efficiencies between Ki-67-positive and negative Luminal B patients were not significantly different(P>0.05). Conclusion: Expression of Ki-67 and LRP proteins varies in different breast cancer subtypes. Overexpression of LRP in Luminal B breast cancer might be correlated with the chemotherapy efficiency after surgery.