早期宫颈癌局部浸润与临床预后关系的研究

Retrospective Study on Local Invasion Associated with Proteins Expression and Clinical Significance in Early Cervical Carcinoma

目的:探讨早期宫颈癌中局部浸润及其预后意义。方法:应用免疫组织化学检测65例早期宫颈癌中MMP2、MMP9、Cathepsin D、E-cadherin,并利用原位杂交检测HPV的表达,分析其与临床参数和预后之间的关系。结果:MMP2的表达与组织学分型、淋巴结转移、局部复发有关(P<0.05),与UICC分期无关(P>0.05);MMP9的表达与淋巴结转移、局部复发有关(P<0.05),与组织学分型、UICC分期无关(P>0.05);Cathepsin D的表达与组织学分型、淋巴结转移、局部复发、UICC分期均存在相关(P<0.05);E-cadherin的表达与淋巴结转移、UICC分期有关(P<0.05),与局部复发、组织学分型无关(P>0.05);HPV的表达与组织学分型有关(P<0.05),与淋巴结转移、局部复发、UICC分期无关(P>0.05);经多因素Cox比例风险模型分析显示:组织学分型、Cathepsin D、MMP2的表达与早期宫颈癌患者术后生存率有关(P<0.05)。结论:MMP2、MMP9、Cathepsin D、E-cadherin参与了早期宫颈癌的局部浸润;组织学分型、MMP2、Cathepsin D的表达可作为宫颈癌患者独立的预后因素。

Objective： To investigate the local invasion and clinical significance in early Cervical Carcinoma. Methods： The expressions of proteins MMP2, MMPg,CathepsinD,E-cadherin were detected by immmunohistochemistry method, the expression of HPV was detected by in situ hybridization in sixty-five patients with early Cervical Carcinoma who were followed up more than ten years. The relationship between the expression of invasion associated with proteins and clinical prognosis were analysed. Results： the expression of MMP2 was associated with lymph node metastasis, histological grading and recurrence （P〈0. 05）. were not associated with UICC staging（P〉0.05） ; the expression of MMP9 was associated with lymph node metastasis and recurrence （P〈0.05）, was not associated with histological grading , UICC staging（P〉0. 05） ;the expression of CathepsinD was associated with all parameters （P〈0. 05） ;the expression of E-cadherin was associated with lymph node metastasis and UICC grading （P〈0.05）, was not associated with recurrence , histological staging（P〉0.05） ; the expression of HPV was associated with histological staging （P〈0. 05） ,was not associated with lymph node metastasis , UICC grading, recurrence （P〉0. 05） ; in the multivariate Cox analysis, survival rate was correlated with histological staging MMP2 CathepsinD （P〈0.05）. Conclution： MMP2, MMPg,CathepsinD, E-cadherin all take part in invasion of early cervical carcinoma; Histological staging MMP2, CathepsinD can be regarded as independent prognostic factors in early cervical carcinoma.