基质金属蛋白酶-9、血管内皮生长因子和增殖细胞核抗原在胃腺癌表达的相关性及临床意义

The relationship of MMP-9, VEGF and PCNA expressions and their clinical significance in gastric adenocarcinoma

目的研究胃腺癌中基质金属蛋白酶-9（MMP-9）及其相关因子血管内皮生长因子（VEGF）和增殖细胞核抗原（PCNA）蛋白的表达，并分析其临床意义。方法利用组织芯片技术，通过免疫组化法检测45例胃腺癌组织及其相应的45例癌旁组织和10例正常胃黏膜组织中MMP-9、VEGF和PCNA蛋白的表达，并分析它们的相关性及其与胃腺癌的分化程度和发生发展的关系。结果本研究中MMP-9、VEGF和PCNA分别在胃腺癌、癌旁组织、正常胃黏膜中检出的阳性率为：MMP-9，82．2％（37／45）、64．4％（29／45）、30．0％（3／10），差异有统计学意义（P=0．019）；VEGF，73．3％（33／45）、62．2％（28／45）、30．0％（3／10），差异有统计学意义（P=0．029）；PCNA，84．4％（38／45）、71．1％（32／45）、10．0％（1／10），差异有统计学意义（P=0．001）。MMP-9、VEGF和PCNA分别在高、中、低分化胃腺癌组织中的阳性率为：MMP-9，70．0％（7／10）、80．0％（8／10）、88．0％（22／25），差异有统计学意义（P=0．015）；VEGF，50．0％（5／10）、60．0％（6／10）、88．0％（22／25），差异有统计学意义（P=0．000）；PCNA，60．0％（6／10）、90．0％（9／10）、92．0％（23／25），差异有统计学意义（P=0．004）。等级相关分析表明MMP-9、VEGF和PCNA呈两两正相关（P〈0．05）。结论组织芯片技术是胃腺癌中各种蛋白表达的一种强有力的分析工具。MMP-9、VEGF和PCNA蛋白参与胃腺癌的发生发展过程，可以成为临床上评价预后的指标。

Objective To investigate abnormal protein expression of matrix metalloproteinase-9 （MMP-9） , vascular endothelial growth factor （VEGF） and proliferating cell nuclear antigen （ PCNA ） in human gastric adenocarcinoma, and further reveal the clinical significance. Method The MMP-9, VEGF and PCNA proteins expression was determined by immunohistochemistry staining in 45 gastric adenocarcinoma tissues, 45 adjacent specimens and 10 normal gastric mucosa tissues via tissue arrays accordingly. The relationship of these protein expression with differentiation degree, development and progression of gastric adenocarcinoma were also analyzed. Results Positive rates of MMP-9, VEGF and PCNA in gastric adenocarcinoma, adjacent specimens and gastric normal mueosa were as follows： MMP-9, 82. 2% （37/45）, 64.4% （29/45）, 30. 0% （3/10） （P =0.019）; VEGF, 73.3% （33/45）, 62. 2% （28/45）, 30. 0% （3/10） （ P = 0. 029 ） ; PCNA, 84.4% （ 38/45 ）, 71.1% （ 32/45 ）, 10.0% （ 1/10 ）, there were statistically significant difference（ P = 0. 001 ）. The positive rates of MMP-9, VEGF and PCNA in well- differentiated adenocarcinoma, moderately differentiated adenocarcinoma and poorly differentiated were as follows ： MMP-9,70. 0% （7/10）, 80. 0% （ 8/10 ）, 88.0% （22/25）, there were statistically significant difference （P =0. 015） ;VEGF, 50.0% （5/10）, 60. 0% （6/10）, 88. 0% （22/25）, there were statistically significant difference （ P = 0. 000 ） ; PCNA, 60. 0% （6/10） ,90.0% （9/10）, 92.0% （23/25） ,the difference is significant statistically （P = 0. 004 ）. The expression of MMP-9, VEGF and PCNA showed positive relationship with each other by rank correlation analysis （ P 〈 0.05 ）. Conclusion Tissue arrays technology is effective tool to analyze the expression of cancer related proteins in gastric adenocareinoma. The expression of MMP-9, VEGF and PCNA proteins participates in the tumorigenesis and development process of gastric adenocarcinoma, and these can be used as indexes to evaluate prognosis in clinical.