荧光定量RT-PCR检测宫颈癌患者外周血MMP-9 mRNA表达的临床意义

Clinical significance of MMP-9 mRNA detection in the peripheral blood of patients with cervical cancer by fluorescent quantitative RT-PCR

目的研究宫颈癌患者外周血中MMP-9mRNA的表达,探讨其临床意义。方法应用实时荧光定量PCR技术,检测98例经病理证实的宫颈癌及25例妇科良性肿瘤对照组外周血液中MMP-9mRNA的表达,并分析其与临床病理因素的关系。结果 98例宫颈癌组外周血MMP-9mRNA阳性率为76.5%,而对照组为48.0%（P〈0.01）。在宫颈癌组内,早期宫颈癌（Ⅰ-ⅡA期）外周血MMP-9mRNA阳性率为63.5%,而中晚期宫颈癌（Ⅱb-Ⅳ期）为88.6%（P〈0.05）。早期宫颈癌患者MMP-9mRNA的表达与肿瘤分期（ⅠA、ⅠB、ⅡA）、病理类型（鳞癌、非鳞癌）、淋巴转移（＋/-）、肿瘤大小（〈4cm、≥4cm）等均无显著性相关（P〉0.05）。仅与年龄（〈40岁、≥40岁）、组织分化（G1-2、G3）、脉管瘤栓（＋/-））显著相关（P〈0.05）。结论荧光定量PCR技术可检测出各期宫颈癌患者外周血中MMP-9的表达,有较高的敏感性和特异性,在判断宫颈癌预后、监控复发中的应用具有一定的可行性。

Objective To detect the expression of matrix metallopeptidase 9 （MMP-9） mRNA in the peripheral blood of patients with cervical cancer, and to evaluate its clinical significance. Methods The expression of MMP-9 mRNA was evaluated by fluorescent quantitative reverse transcription polymerase chain reaction （RT-PCR） in the peripheral blood of 98 patients with cervical cancer （the study group） and 25 patients with benign gyneco!ogical tumors （the control group）. Possible correlations between clinical pathological factors were analyzed. Results The positive rate of MMP-9 mRNA was 76.5% in the study group and 48% in the control group, with statistically signifi- cant difference （P〈0.01）. In the study group, the positive rate of MMP-9 mRNA was 63.5% in patients with FIGO Stage I A to II A cervical cancer and 88.6% in patients with FIGO Stage IIb to 1V cervical cancer. The expression of MMP-9 mRNA in patients with FIGO Stage I A to II A cervical caner was significantly correlated with age, differentiation and lymph vascular space involvement, but showed no correlation with tumor staging （ I A, I B, II A）, patho- logical types （squamous Cell Carcinoma or non-squamous-cell carcinomas）, lymph node metastasis （＋/-） and tumor size （〈4 cm, ≥4 cm）. Conclusion Fluorescent quantitative RT-PCR can detect the expression of MMP-9 in the peripheral blood of patients with cervical cancer, with high sensitivity and specificity, which could be a potential bio- marker for detecting micrometastasis in cervical carcinoma.