乳腺癌基质金属蛋白酶-9及前哨淋巴结CK19 mRNA表达的相关性

Relationship between matrix metallo-proteinases-9 and CK19 mRNA expression in sentinel lymph nodes in breast cancer

目的:研究乳腺癌组织中基质金属蛋白酶(matrixmetallo-proteinases-9,MMP-9)基因表达与乳腺癌前哨淋巴结(SLN)微转移分子CK19 mRNA检测的关系,揭示乳腺癌的浸润和转移机制。方法:应用S-P免疫组化法检测76例乳腺浸润癌组织和20例乳腺非恶性肿瘤组织中MMP-9的表达情况;采用原位杂交技术检测同组76例乳腺浸润癌SLN微转移分子CK19 mRNA的表达,同时与常规病检法比较其检测敏感性,并比较淋巴结转移组、微转移组、无转移组患者的临床资料。结果:76例乳腺浸润癌中,常规病检无淋巴结转移36例,淋巴结转移40例。MMP-9在淋巴结转移组和无淋巴结转移组原发灶阳性表达的平均秩次为45.95、30.19,转移组明显高于无转移组,两者差异具有显著性(P<0.05)。原位杂交法检出36例阴性淋巴结中9例有CK19 mRNA表达,原位杂交法与常规病检法转移的检出率比较差异有统计学意义(P<0.05)。结论:淋巴结的转移与MMP-9的表达具有相关性,检测MMP-9蛋白表达将有助于判断乳腺癌的转移及预后。应用原位杂交法可明显提高乳腺癌的检出率。

Objective To investigate the relationship between matrix metallo-proteinases-9 （MMP-9） gene expression and detection of CK19 mRNA in sentinel lymph nodes （SLNs） in breast cancer, and to illustrate the mechanism of invasion and metastasis of breast cancer. Methods The levels of MMP-9 expression were detected by immunohistochemistry in 76 specimens of invasive breast carcinomas and 20 benign breast neoplasms, and in situ hybridization, whose sensitivity was simuhaneously assessed by the routine pathological analysis, was used to examine CK19 mRNA expression in SLNs in the same 76 patients. The clinical data were compared among the metastasis group, micrometastasis group, and non-metastasis group. Results Of 76 cases of invasive breast carcinomas, 36 were negative in lymph node metastasis but 40 were positive under the routine detection. MMP-9 expression in the primary lesions was significant higher in lymph node metastasis than in non-lymph node metastasis（P 〈 0.05）, with an average sum of ranks of 45.95 and 30.19. Micrometastasis to SLNs was positively related to MMP-9 expression. CK19 mRNA was expressed in 9 out of 36 negative nodal involvements which were detected by in site hybridization. There was significant difference in the detection rate of lymph node metastasis between in situ hybridization and the routine pathological examination （P 〈 0.05）. Conclusion The lymph node metastasis is correlated with MMP-9 expression, Detection of MMP-9 expression may be helpful in predicting metastasis of breast cancer, The use of in site hybridization can markedly improve the detection rate of breast cancer.