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Expression of Multidrug Resistance Protein and Messenger RNA Correlate with ^99mTc-MIBI Imaging in Patients with Lung Cancer

Departments of Radiology and Pathology and Division of Tropical Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan

View larger version (75K): [in a new window]   FIGURE 1. Patient 1, 73-y-old man with 2.8 x 2.8 cm lung adenocarcinoma. (A) CT scan shows nodule in right lung. (B) Early 99mTc-MIBI SPECT scan (left) shows intense uptake (arrow) of 99mTc-MIBI in tumor (L/Ne = 3.81). Delayed scan (right) shows faint 99mTc-MIBI uptake in tumor (L/Nd = 1.00), suggesting rapid washout of 99mTc-MIBI from tumor (L/Nwr = 73.8%). Immunohistochemistry (x200) reveals strong Pgp expression (C), strong MRP expression (D), and weak LRP expression (E) in corresponding tumor tissue.

View larger version (90K): [in a new window]   FIGURE 2. Patient 34, 68-y-old woman with 3.6 x 3.6 cm lung adenocarcinoma. (A) CT scan shows nodule in right lung. (B) Early 99mTc-MIBI SPECT scan (left) shows intense uptake of 99mTc-MIBI in tumor (L/Ne = 3.65). Delayed scan (right) also shows intense 99mTc-MIBI uptake in tumor (L/Nd = 5.17), suggesting slow washout of 99mTc-MIBI from tumor (L/Nwr = -41.6%). Immunohistochemistry (x200) reveals negative Pgp expression (C), negative MRP expression (D), and strong LRP expression (E) in corresponding tumor tissue.

View larger version (13K): [in a new window]   FIGURE 3. Relationship between expression of Pgp, MRP, or LRP and 99mTc-MIBI L/Nd in lung cancer. (A) L/Nd correlated inversely with density of Pgp expression. Statistically significant difference in L/Nd was found between Pgp (-) group and Pgp (++) group. (B) No significant difference (n.s.) in L/Nd was found among MRP (++), MRP (+), and MRP (-) groups. (C) No significant difference in L/Nd was found among LRP (++), LRP (+), and LRP (-) groups.

View larger version (13K): [in a new window]   FIGURE 4. Relationship between expression of Pgp, MRP, or LRP and 99mTc-MIBI L/Nwr in lung cancer. (A) L/Nwr correlated with density of Pgp expression. Statistically significant difference in L/Nwr was found between Pgp (++) group and Pgp (-) group. (B) No significant difference (n.s.) in L/Nwr was found among MRP(++), MRP (+), and MRP (-) groups. (C) No significant difference in L/Nwr was found among LRP (++), LRP (+), and LRP (-) groups.

View larger version (17K): [in a new window]   FIGURE 5. Relationship between Pgp mRNA expression and 99mTc-MIBI L/Nd or 99mTc-MIBI L/Nwr in lung cancer. (A) L/Nd correlated inversely with Pgp mRNA level. Statistically significant difference in L/Nd was found between Pgp mRNA low-expression group and Pgp mRNA high-expression group. (B) Statistical support was found toward a significant difference in L/Nwr between Pgp mRNA high-expression group and Pgp mRNA low-expression group.