MMP-9在胃癌及其淋巴结组织中表达的临床意义

Expression and Clinical Significance of MMP-9 in Gastric Cancer and Metastatic Lymph Nodes

目的:研究MMP-9在胃癌组织中的表达状况,分析其与临床病理特征和生存之间的关系。方法:应用免疫组化SP法,采用组织芯片技术,分析189例胃癌、54例癌旁组织、41例淋巴结转移灶及32例正常对照组织中c-Jun和MMP-9蛋白表达。结果:胃癌中MMP-9蛋白的阳性表达率为78.3%。MMP-9的表达与浸润深度、淋巴结转移、分化程度及Lauren分型有关(P<0.05)。41例淋巴结转移灶和相对应的41例胃癌组织各因子表达比较发现,MMP-9阳性表达率具有显著性差异(P<0.05)。与MVD进行比较发现,MMP-9阳性患者的MVD值高于阴性组,差异有统计学意义(P<0.05)。单因素生存分析显示MMP-9阳性组对胃癌患者生存期的影响有统计学意义(P<0.05),Cox多因素回归分析显示MMP-9的异常表达不能作为影响胃癌预后的独立因素(P>0.05)。结论:MMP-9在胃癌组织中均有高表达。MMP-9阳性表达与肿瘤的浸润、转移密切相关,可作为判断胃癌恶性行为的重要生物学标记物。MMP-9在促进血管生成中起重要作用。MMP-9蛋白阳性表达对胃癌患者来说是一个不利的预后因素,但尚不能作为一个独立的预后指标。

Objective： To investigate the expression of MMP-9 in gastric cancer, para-cancerous tissue and metastastic lymph nodes and to explore its relationship with the clinicopathologic features and prognosis. Methods： Immunohistochemistry was used to detect the expression of MMP-9 on tissue microarray containing gastric normal mucosa （n=32）, para-cancerous tissue （n=54）, metastastic lymph nodes （n=41）, and gastric cancer tissue （n=189）. Results： The positive rate of MMP-9 expression was 78.3% in gastric cancer tissues. The positive rate of MMP-9 expression was associated with depth of invasion, lymph node metastasis, Lauren type and degree of differentiation （P〈0.05）, but was not associated with sex, age, or tumor size （P〉0.05）. There was a significant difference in MMP-9 expression between gastric cancer tissues and metastastic lymph nodes （P〈0.05）. In metastastic lymph nodes, the positive rate of MMP-9 expression was higher. The MVD in MMP-9 positive tissues tended to be greater than that in MMP-9 negative tissues, with a statistical significance （P〈 0.05）. Kaplan-Meier survival analysis showed that the survival of patients without MMP-9 expression was longer than those with positive MMP-9 expression （P〈0.05）. COX regression analysis revealed that MMP-9 expression was not an indepen- dent prognostic factor for gastric cancer. Conclusion： The higher expression of MMP-9 involves the occurrence, progression, invasion, and metastasis of gastric cancer. MMP-9 can be used as a metastatic predictor and prognostic marker for gastric cancer. MMP-9 may promote angiogenesis. But MMP-9 is not an independent prognostic indicator for gastric cancer.