肝癌患者血清及肿瘤组织MMP-2/9的表达及意义

The Expression and Clinical Value of MMP-2 and MMP-9 in Hepatocellular Carcinoma

目的有关MMP-2/9用于预测肝癌患者预后的报道结果不一。本研究旨在探讨肝癌患者血清及肿瘤组织中MMP-2/9的表达情况及其在预测肝癌侵袭和患者预后的意义。方法按随访结果将64例肝癌患者分为复发组(n=42)与未复发组(n=22),采用酶联免疫吸附和免疫组化方法检测两组患者的术前血清以及手术切除标本中MMP-2/9的表达情况。结果复发组与未复发组相比,前者血清MMP-2/9的浓度明显高于后者(P<0.05)。肝癌组织中MMP-2/9表达于胞浆中,复发组阳性率分别为73.8%及59.5%,未复发组分别为40.9%及18.2%(P<0.05)。MMP-2阴性组的1、2、3年无瘤生存率分别为76.0%、60.0%及56.0%,阳性组的分别为48.7%、30.8%及25.6%(P<0.01);MMP-9阴性组的分别为77.1%、65.8%及57.1%,MMP-9阳性组的分别为37.9%、13.8%及13.8%(P<0.01)。多因素分析表明术前播散结节、微转移灶及MMP-2/9的表达水平是影响患者预后的独立危险因素。结论肝癌患者血清及肿瘤组织中MMP-2/9的表达水平明显升高,与肝癌患者的术后复发相关。

Objective The reports on the value of MMP-2/9 in estimating the prognosis of HCC patients are controversial. This study is to investigate the expression and clinical value of MMP-2/9 in estimating the invasion and prognosis of HCC. Methods The expression of MMP-2/9 in 64 serum and resection specimens of HCC was detected by enzyme-linked immunosorbent assay（ELISA） and immunohistoche-mistry. Of the 64 patients,42 had tumor recurred after operation. Correlations of the expression of MMP-2/9 to clinicopathologic features were analyzed. Results The serum level of MMP-2/9 was significantly higher in recurrent group than in non-recurrent group（P 0.05） ,respectively. MMP-2/9 was expressed in cytoplasm,respectively. The positive rate of MMP-2/9 was significantly higher in recurrent group than in non-recurrent group（73.8% vs. 40.9%,59.5% vs. 18.2%,P 0.05） ,respectively. The 1-,2-,and 3-year tumor-freely survival rates were significantly higher in MMP-2（-） group than in MMP-2（＋） group（76.0% vs. 48.7%,60.0% vs. 30.8%,56.0% vs. 25.6%,P 0.01） ,and were significantly higher in MMP-9（-） group than in MMP-9（＋） group（77.1% vs. 37.9%,65.8% vs. 13.8%,and 57.1% vs. 13.8%,P 0.01） . Multivariate analysis revealed that preoperative disseminated nodes,tumor micrometastasis,and the expression of MMP-2/9 were independent recurrence risk factors. Conclusion The expression of MMP-2/9 in serum and specimens of HCC patients ascends distinctly,which correlates to the recurrence of HCC after hepatectomy.