VEGF、明胶酶在声门上喉癌、下咽癌转移淋巴结表达及临床意义

Expression and Clinicl Value of VEGF,MMP-2 in Supraglottic and Hypopharyngeal Carcinoma and Metastasic Lymph Node

目的 探讨声门上喉癌、下咽癌瘤体、周围组织及转移淋巴结VEGF、基质金属蛋白酶-2（MMP2）的表达情况以及两种分子标志物在肿瘤表达的相关性.方法采用免疫组化SP法及图像分析法,检测38例肿瘤瘤体及不同距离手术切缘组织、转移淋巴结VEGF,MMP-2的表达情况.结果 ①喉及下咽部鳞癌组织VEGF表达阳性率为89％（ 34/38）,高于癌周切缘及正常组织,VEGF表达强度与肿瘤病理分级、临床分期、淋巴结转移相关.VEGF在声门上喉癌及下咽癌瘤体、5mm,10mm表达阳性率10mm→5 mm→瘤体依次递增.②在喉及下咽部鳞癌组织中MMP-2阳性表达率为73.6％ （28/38）,淋巴结转移组明显高于无淋巴结转移组,T3 -T4组明显高于T1-T2组.而MMP-2与肿瘤位置及病理分级无关.MMP-2在声门上喉癌及下咽癌瘤体、5mm,10mm中的表达阳性率10mm→5mm→瘤体依次递增.③MMP-2在正常淋巴结无表达,在转移淋巴结表达阳性率为28％（14/53）,VEGF在转移淋巴结中的阳性表达率42％ （22/53）,正常淋巴结无表达.④VEGF与MMP-2无相关性结论VEGF,MMP-2在喉癌及下咽癌瘤体中的表达高于癌周正常组织,VEGF在瘤体及癌周正常组织表达阳性率高于MMP-2.VEGF,MMP-2可作为预测喉癌及下咽癌浸润生长、转移的敏感标志物.

Objective To explore tile expression nf vascular endothelial growth faetor（VEGF） and matrix metalloprnteinase-2 （MMI）-2） in supraglottie and hypopharyngeal careinoma and different distance surgical margins and to analyse their role in lymphatic metas- tasis; to explore the relativity of twn molecular marker. Methods Expressinn of VEGF and MMP-2 ill carcinoma and different margins were detected by HE-stained,rnutine pathological section and immuohistochemical SP method,image analysis. Results （1）Staining positive rate of VEGF in supraglottic and hypopharyngeal carcinoma was 89% （ 34/38 ）. There was significant association between VEGF expl^ssion intensity and elinical stage,lymphic metastasis. The positive expression rate of VEGF was increased in secluence from 10mm,5mm distant mucosa tis- sue to cmx.inoma nest in supragloltic and hypopharyngeal carcinoma. （2）MMP-2 ：Immunohistochemical staining for MMP-2 was performed with a monoclonal anti-MMP-2 antibody. The positive expression rate was 73.6% （ 28/38 ）. There was significant difference between lymph node metas）asis and no lymph node metastasis,but there was not significant difference between T3 and T4 or T1 and T2 { P 〉 0.05 ）. There was no sig,lificant difference between MMP-2 and carcinoma t）osition, pathology grade（P 〉 0.05）. Positive expression rate of MMP-2 was increased in 5ram, 10mm different distant margin of supraglottic and hypnpharyngeal carcinoma as tissue progressed adjacent to careinoma. （~）Negative expression of MMP-2 and VEGF was seen in the normal lymph nodes. MMP-2 positive expression rate was 28% in metastasic lymph nodes, VEGF was 42%. （4）There was no significant correlation between VEGF and MMP-2 in margins according to spearman rank correlation test. Conclusion VEGF and MMP-2 expression was significantly higher in supraglotlie and hypopharyngeal carcinoma than distant margin and normal mucosa tissue. VEGF positive rate was higher than MMP-2, expression sensitivity and reliability of VEGF in margins was a higher than MMP-2. VEGF, MMP-2 is a sensitive marker in growth, penetration of supraglottic and hypopharyngeal carcinoma.