基质金属蛋白酶-2在肾上腺皮质腺癌中的诊断价值

Diagnostic significance of matrix metalloproteinase type 2 expression in malignant adrenocortical tumors

目的探讨基质金属蛋白酶-2(MMP-2)在肾上腺皮质腺癌中的诊断价值。方法应用免疫组化EnVision法检测16例肾上腺皮质腺癌和34例皮质腺瘤中MMP-2和Ki-67的表达。结果16例肾上腺皮质腺癌中12例MMP-2(+),其中5例局灶(+),7例弥漫(+);而34例皮质腺瘤中仅有3例MMP-2局灶弱(+)(P<0.01)。3例MMP-2(+)的皮质腺瘤中2例分别在术后3年和5年复发。腺癌中10例Ki-67≥5%,1例<1%;腺瘤中24例Ki-67<1%,3例≥5%。结论MMP-2有助于肾上腺皮质腺瘤和腺癌的鉴别,并有望成为肾上腺皮质腺癌新的预后指标,检测肾上腺皮质腺瘤中MMP-2的表达可以预测腺瘤复发。

Purpose To investigate the diagnostic significance of matrix metalloproteinase type 2 expression in malignant adrenocortical tumors. Methods The matrix metallopmteinase type 2 expression was analyzed by EnVision method in a series of 16 adrenocortical carcinomas and 34 adrenocortical adenomas. Results Matrix metalloproteinase type 2 was detected in neoplastic cells in 12/16 （75%） adrenocortical eareinomas, with a focal （ 〈 20% of positive cells-5/12 of eases） or diffuse （≥20% of positive cells-7/12, of cases） pattern, and in 3/34 （8.8%） adrenocortical adenomas with a focal pattern （P 〈 0.01 ）, two of which recurred in 3 and 5 years respectively after surgery. 10/16 eases of adrenocortieal carcinomas （62.5%） had a high Ki-67 index （≥5%）, and 1/16 （6.25%） had a low index （ 〈 1% ）; while 24/34 （70.6%） eases of adrenocortieal adenomas had a low Ki-67 index （ 〈 1% ）, and 3/34 （ 8.8 % ） had a high one （≥5 % ）. Conclusion The differential diagnosis of adrenocortical tumors can be benefited from the detection of matrix metalloproteinase type 2, which may be a new predictive index of adrenocortical carcinoma, and whose expression in adrenocortical adenomas can predict its recurrence.