血浆MMPs活性检测对甲状腺乳头状癌患者的临床意义

Change and significance of the serous activity of matrix metalloproteinases in patients with papillary thyroid carcinoma

目的本研究观察血浆基质金属蛋白酶MMP-2和MMP-9活性与甲状腺乳头状癌侵袭和转移的关系,以探讨其临床意义。方法本院1999年-2003年共有明确病理结果、无基础疾病史并经检查排除相关疾病的甲状腺乳头状癌患者74例,所有患者行甲状腺癌改良根治术(肿瘤侧腺叶全切加夹部切除加对侧次全切,颈部淋巴结清扫),术后依照病理结果分组,并用明胶酶谱法测定患者血浆MMP-2和MMP-9活性。检测结果采用SPSS10.0forwindows软件包进行t检验。结果淋巴结转移组的血浆MMP-2(62KD)和MMP-9(82KD)活性(71.93±11.72、15.50±6.06)明显高于无淋巴结转移组(35.16±6.63、7.27±2.30)(P<0.001);包膜及包膜外浸润组的血浆MMP-2(62KD)和MMP-9(82KD)活性(70.46±13.04、14.67±6.13)明显高于包膜内浸润组(35.43±7.92、8.04±4.23)(P<0.001);而肿瘤直径≥1cm组和<1cm组血浆MMP-2(62KD)和MMP-9(82KD)活性(55.43±20.38vs59.30±20.77,10.85±5.72vs13.71±6.77)无显著差别(P>0.05),各组之间MMP-2(62KD+72KD)和MMP-9(82KD+92KD)活性无显著差别(P>0.05)。结论明胶酶的活化形式MMP-2(62KD)和MMP-9(82KD)和甲状腺乳头状癌转移与侵袭有关,和肿瘤的大小无关,可作为术前评估的重要指标。

Objective To study relationship between activity of matrix metalloproteinases (MMP-2 and-9) and invasion,metastasis of papillary thyroid carcinoma. Methods The serous activity of matrix metalloproteinases-2 and-9 of 74 patients with papillary thyroid carcinoma was measured by zymography. All of patients had a reformative radical cure operation. Results It was found that the serous activity of MMP -2 (62 KD) and MMP - 9 (82 KD) were apparently higher in patients with lymph node metastases (71.93±11.72, 15.50±6.06) and invasive carcinomas (70.46±13.04,14.67±6.13) than that in patients with no lymph node metastases (35.16±6.63,7.27±2.30) and invasive carcinomas (35.43±7.92,8.04±4.23), P< 0.001, respectively. There was no difference (P>0.05) in the serous activity of MMP - 2 (62 KD) and MMP -9(82 KD) of patients with different size tumor (55.43±20.38 to 59.30±20.77,10.85±5.72 to 13.71±6.77). There was also no difference in the serous activity of MMP-2(62 KD + 72 KD) and MMP-9 (82 KD + 92 KD) of patients with different size, invasion and metastases papillary thyroid carcinoma. Conclusion These results demonstrated a clear relationship between MMP - 2 (62 KD) and MMP - 9 (82 KD) activity and the invasion and metastsis of papillary thyroid carcinoma, but there was no relationship between the activity and the size of tumor. Preoperative measurement of serous activity of MMP - 2 (62 KD) and MMP - 9 (82 KD) is helpful in the diagnosis, evaluation and prediction of prognosis.