组织中MMP-9、E-cadherin与子宫内膜样癌伴MELF浸润方式及肿瘤侵袭程度的关系

The relationship of MMP-9,E-cadherin in tissues with MELF pattern invasion and degree of tumor invasion in endometrial carcinoma

目的分析子宫内膜样癌组织中基质金属蛋白酶(matrix metalloproteinase,MMP)-9、E-钙黏蛋白(E-cadherin)与微囊性、伸长及碎片状(microcystic,elongation,and fragmentation,MELF)浸润方式及肿瘤侵袭程度之间的关系,探讨能够识别子宫内膜样癌伴MELF浸润的指标,抑制肿瘤侵袭能力。方法回顾性分析在河北北方学院附属第一医院接受手术治疗的112例子宫内膜样癌患者临床资料,全部患者均顺利完成改良根治性子宫切除术,并获得肿瘤标准,根据病理检查结果对112例患者进行分组,分为MELF组和N-MELF组。统计112例患者一般临床资料,血液检查项目包括肿瘤标志物,免疫组织化学检查项目包括组织中MMP-9、E-cadherin,根据检查结果,构建Logistic回归模型,分析组织中MMP-9、E-cadherin及相关指标与子宫内膜样癌MELF浸润方式及肿瘤侵袭程度的关系。结果研究中112例子宫内膜样癌患者,评估为MELF浸润患者21例(18.75%);MELF浸润患者病理等级低级别,国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)ⅣA期,淋巴脉管间隙浸润(lymphatic vascular space,LVSI)、组织中MMP-9阳性患者占比多于N-MELF浸润患者,E-cadherin阳性患者占比少于N-MELF浸润患者,人附睾蛋白(humanepididymisprotein 4,HE4),甲壳质酶蛋白(human cartilageglycopmtein,YKL-40)水平高于N-MELF患者,差异有统计学意义(P<0.05)。多元Logistic回归分析提示,组织中E-cadherin表达率低、MMP-9表达率高,MELF浸润与子宫内膜样癌FIGO分期进展有关(P<0.05)。结论子宫内膜样癌发生MELF浸润与组织中MMP-9、E-cadherin有关,MMP-9表达率高和E-cadherin表达率低能够通过导致MELF浸润发生,从而增强肿瘤侵袭能力。

Objective To analyze the relationship of matrix metalloproteinase-9(MMP-9),and E-cadherin in endometrioid carcinoma tissues with the microencystic,elongated and fragmented(MELF)pattern invasion and degree of tumor invasion,and to explore the indicators that could identify the endometrial carcinoma with MELF invasion,so as to inhibit tumor invasion.Methods A retrospective analysis was conducted on the clinical data of 112 patients with endometrioid carcinoma who underwent surgical treatment at the First Affiliated Hospital of Hebei North University.All patients successfully completed modified radical hysterectomy and met tumor criteria.Based on pathological examination results,112 patients were divided into MELF group and non-MELF(N-MELF)group.The general clinical data of 112 patients were recorded.The blood examination items included tumor markers,and immunohistochemical examination items included MMP-9 and E-cadherin in tissues.According to the results of the examination,a Logistic regression model was constructed to analyze the relationship of MMP-9,E-cadherin and related indicators in the tissue with the MELF pattern invasion and degree of tumor invasion of endometrial carcinoma.Results Among the 112 patients with endometrioid carcinoma in this study,21 patients(18.75%)were evaluated as MELF invasion.The proportion of patients with low pathological grade of MELF invasion,the International Federation of Gynecology and Obstetrics(FIGO)stageⅣA,lymphatic vascular space invasion(LVSI),and positive MMP-9 in tissues was higher than that of N-MELF invasion patients,and the proportion of E-cadherin positive patients was lower than that of N-MELF invasion patients.The levels of human epididymis protein 4(HE4)and human cartilage glycopmtein(YKL-40)were higher than those of N-MELF patients,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the expression rate of E-cadherin was low,that the expression rate of MMP-9 was high in tissues,and that MELF invasion was related to FIGO staging of endometrial carcinoma(P<0.05).Conclusion The MELF invasion of endometrioid carcinoma is related to MMP-9 and E-cadherin in the tissues.The high expression rate of MMP-9 and the low expression rate of E-cadherin can lead to the MELF invasion and hence enhance the tumor invasion ability.