Cath-D和MMP-9的表达与膀胱移行细胞癌复发转移及预后的关系

Expressions of Cath-D and MMP-9 associated with recurrence metastasis and prognosis of bladder transitional cell carcinoma

目的探讨组织蛋白酶D(Cath-D)和基质金属蛋白酶9(MMP-9)在膀胱移行细胞癌(BTCC)中的表达及其与肿瘤临床病理、术后复发、转移及预后的关系。方法采用免疫组化(SP法)检测60例BTCC和10例正常膀胱组织中Cath-D及MMP-9的表达。结果在10例正常膀胱组织中均呈阴性或弱阳性表达。60例BTCC中均呈弱阳性或强阳性表达,强阳性表达率分别为45%和38.3%。高分期组及复发组中Cath-D的强阳性表达率均分别高于低分期组及初发组(P<0.05);高分期组、高分级组及复发组中MMP-9强阳性表达率均分别高于低分期组、低分级组及初发组(P<0.05)。BTCC中Cath-D与MMP-9强阳性表达组的术后复发、转移率均高于弱阳性表达组(P<0.05),而术后生存率则低于弱阳性表达组(P<0.05)。Spearman等级相关性分析显示二者的表达存在显著的相关性(r=0.458,P<0.01)。高分期、高分级组中二者均强阳性表达的比率高于单个强阳性表达的比率及均弱阳性表达的比率(P<0.05)。二者均强阳性表达组的术后复发转移率高于单个强阳性表达组及均弱阳性表达组(P<0.05),而术后生存率则低于单个强阳性表达组和均弱阳性表达组(P<0.05)。结论Cath-D及MMP-9的表达水平与BTCC的临床分期、病理分级、复发转移及预后密切相关,可望成为判断BTCC复发、转移和预后的辅助指标。

[Objective] To evaluate the expressions of cathepsin-D （Cath-D）and matrix metalloproteinase-9 （MMP-9） in bladder transitional cell carcinoma （BTCC） and to determine their relationship with clinic pathological characters, recurrence metastasis and survival. [Method] Immunohistochemistry was used to detect the expressions of Cath-D and MMP-9 in 60 tissues of BTCC and 10 tissues of normal mucosa of bladder. [Results] The expressions of Cath-D and MMP-9 were all weakly or strongly positive in 60 tissues of BTCC, and the stongly positivity rate of Cath-D and MMP-9 in BTCC were 45% and 38.3%; while in normal controls all were weakly positive or negative.The strongly positive rate of Cath-D in BTCC closely correlated with higher clinicalstages （P 〈0.05） and postoperative recurrence （P 〈0.05）. The strongly positive rate of MMP-9 in BTCC closely correlated with poorly pathologlcalgrades （P 〈0.05）, higher clinicalstages （P 〈0.05） and postoperative recurrence （P 〈0.05）. The postoperative follow-up showed that the group of Cath-D strongly positive had a higher risk of recurrence/metastasis and a lower survival rat than the group of weakly positive, and so did the group of MMP-9 strongly positive. The analyse of Spearman rank correlation showed that the expressions of Cath-D and MMP-9 closely correlated with each other （r=0.458, P 〈0.01）. In T3~T4 and poorly differentiated BTCC, the rat of both Cath-D and MMP-9 strongly positive was higher than the rate of Cath-D or MMP-9 separately strongly positive, and also higher than the rate of both Cath-D and MMP-9 weakly positive. The group of both Cath-D and MMP-9 strongly positive had a higher risk of recurrence/metastasis and a lower survival rate than the group of Cath-D or MMP-9 separately strongly positive, and the group of both Cath-D and MMP-9 weakly positive. [Coneluslons] The expression of Cath-D and MMP-9 closely correlated with the clinical stage and pathological grade of BTCC, and affected the risk of recurrence/metastasis and the prognosis of BTCC. It was suggested that they may be of great value in predicting the prognosis of patients with BTCC.