Expression of multidrug resistance-related P-glycoprotein shows good prognosis in neuroblastoma

Expression of P-glycoprotein was studied in formalin-fixed tissue sections from 75 materials with an immunoperoxidase (ABC) method using the monoclonal antibody MRK-16. Specimens examined were from three monkey fetuses, eight autopsy cases, and 64 neuroblastoma patients, 25 of whom were underwent mass screening for diagnosis. P-glycoprotein test results were positive in fetal lung alveolar tissue and in the adrenal medulla of three of seven adult autopsy cases. Expression of P-glycoprotein was demonstrated in 22 of 35 cases (63%) in a group of neuroblastoma patients younger than 12 months of age, as compared with 9 of 20 (31%) who were older than 12 months of age at diagnosis. P-glycoprotein positivity was higher in patients who were alive (25 of 40, 63%) than in those who had died (6 of 24, 25%). Previous studies on P-glycoprotein expression in neuroblastoma were carried out using specimens mainly from older children, and the results were not analyzed with reference to the findings in normal tissues. The present study has clearly shown that positive P-glycoprotein expression in neuroblastoma patients should be evaluated carefully in infant cases because it stains frequently in normal adrenal glands.