肝癌辨证分型与基质降解的相关性研究

Correlation of Syndrome Differentiation of Liver Cancer with Matrix Degradation

目的:探讨肝癌辨证分型与肝癌细胞基质降解的关系。方法:收集106例肝癌切除术后患者,分为肝郁脾虚型、气血瘀滞型、湿热蕴结型、肝肾阴虚型,采用免疫组化法检测癌灶、癌旁、远癌正常肝组织在不同辨证分型肝癌中基质金属蛋白酶(MMP2)、基质金属蛋白酶抑制剂(TMP2)及MMP2/TMP2值的差异;同时收集临床病理参数,分析基质降解与肝癌辨证分型、转移相关临床病理参数之间的关系。结果:各种辨证分型中癌灶内MMP2、TMP2表达与癌旁、远癌正常组织中有明显差别(P<0.05)。癌灶内不同证型MMP2、TMP2、MMP2/TMP2表达:肝郁脾虚型和肝肾阴虚型MMP2蛋白表达高于气血瘀滞和湿热蕴结型,其中湿热蕴结型和肝肾阴虚型之间差异有显著性意义(P<0.05);TMP2在各种辨证分型中变化不大;肝郁脾虚型和肝肾阴虚型MMP2/TMP2明显高于气血瘀滞和湿热蕴结型(P<0.05),但肝郁脾虚型和肝肾阴虚型之间、气血瘀滞和湿热蕴结型之间差异无显著性意义。湿热蕴结型和肝肾阴虚型中癌栓发生率明显高于其它2型(P<0.05)。肝功能随着辨证分型变化有明显演进趋势。结论:原发性肝癌的辨证分型与基质降解密切相关,肝郁脾虚型主要以MMP2升高,湿热蕴结型、气血瘀滞型MMP2、TMP2均升高,肝肾阴虚型则主要表现为MMP2/TMP2值升高;基质降解与门静脉癌栓有关,但与肝功能无关。

Objective:To investigate the correlation of syndrome differentiation or,liver cancer with matrix degradation.Methods:One hundred and six liver postoperative cancer patients were classi- fied into the syndromes of liver stagnation and spleen deficiency(pattern 1),Qi stagnation and blood stasis(pattern 2),accumulation of damp-heat(pattern 3),and deficiency of liver and kid- ney yin(pattern 4).The expression of matrix metalloproteinase-2(MMP2)and its inhibitor TMMP2as well as their ratio were compared in the cancer tissue,para-cancer tissue and normal liver tissue.The relationship of matrix degradation with syndrome patterns,clinical pathological pa- rameters of cancer metastasis was investigated.Results:The MMP2 protein expression as well as MMP2/TMP2 was obviously higher in pattern 1 and pattern 4 than that in patter 2 and pattern 3(P<0.05).The changes of expression of TMP2 was not obvious in the different syndromes.The dif- ferouee of MMP2/TMP2 was insignificant between pattern 1 and pattern 4,as well as between pat- tern 2 and pattern 3.The incidence of cancer emhalus was higher in pattern 3 and pattern 4 than that in pattern 1 and pattern 2(P<0.05).The expression of MMP2 and TMP2 was differed in the cancer tissue,para-cancer tissue and normal liver tissue(P<0.05).The damage of hepatic function increased with the progrnss of syndrome patterns.Conclusion:There exists a correlation of syndrome differentiation of primary liver cancer with matrix degradation:MMF2 expression increases in pattern 1,MMP2 and TMP2 increases in pattern 2 and pattern 3,MMP2/TMP2 increases in patter 4.Matrix degradation is related with the existence of portal venous cancer embolus,but has no relationship with hepatic function.