小肠腺癌患者中MMP-9、Ki-67、EGFR和VEGF的表达与临床特征及预后的相关性研究

Correlation between the expression of MMP-9,Ki-67,EGFR,VEGF and clinical characteristics and prognosis in small intestine adenocarcinoma

目的探讨小肠腺癌组织中金属蛋白酶9(MMP9)、Ki-67、表皮生长因子受体(EGFR)和血管内皮生长因子(VEGF)的表达与临床及预后的关系。方法采用免疫组化法检测75例小肠腺癌患者的MMP-9、Ki-67、EGFR和VEGF的表达,并分析其与患者临床特征及预后的关系。结果 MMP-9、Ki-67、EGFR和VEGF在小肠腺癌中的表达与患者性别、年龄、肿瘤原发部位均无关,但与淋巴结转移和TNM分期均相关(P<0.05);Ki-67和EGFR与肿瘤浸润深度相关(P<0.05);MMP-9、Ki-67和EGFR与肿瘤分化程度相关(P<0.05)。MMP-9、Ki-67、EGFR与预后明显相关,高表达患者的5年生存率(OSR)和中位生存期(MST)均小于低表达的患者(P<0.05),VEGF与预后无明显相关;分化程度、分期和Ki-67是影响小肠腺癌患者预后的独立因素(P<0.05)。术后接受放化疗的患者与未接受治疗患者相比,预后未见明显改善。结论 MMP-9、Ki-67、EGFR、VEGF可作为判断小肠腺癌生物学行为的参考指标,MMP-9、Ki-67和EGFR的表达和预后密切相关。

Objective To evaluate the correlation between the expression of MMP-9, Ki-67, EGFR, VEGF and clinical characteristics and prognosis in small intestine adenocarcinoma. Methods Immunohistochemistry （IHC） was used to assess the expression of matrix metalloproteinase 9 （MMP-9） , Ki-67, pidermal growth factor receptor （EGFR） and vascular endothelial growth factor（VEGF） in resected samples of cancer tissues of 75 small intestine adenocarcinoma patients. The correlation between the expression and the patients＇ clinical characteristics and the prognosis was analyzed. Results The expression of MMP-9, Ki-67,EGFR and VEGF were not related to sex, age, and tumor position, but all related to lymph node metastasis and TNM clinical stage （P 〈 0. 05 ）. The expression of Ki-67 and EGFR were related to the depth of tumor invasion, and also correlation existed among the expressions of MMP-9, Ki-67, EGFR and tumor differentiation （P 〈 0.05）. MMP-9, Ki-67 and EGFR were related to the prognosis. The 5-year OSR and MST of high-expression group of MMP-9, Ki-67, EGFR were lower and shorter than low-expression group （P 〈 0. 05 ） , but there was no obvious difference with VEGF. Cox analysis showed that tumor differentiation, clinical stage and Ki-67 were independent prognosis factors for small intestine adenocarcinoma （P 〈 0. 05 ）. There was no obvious difference of prognosis between the patients who accepted chemotherapy or radiotherapy and accepted neither chemotherapy nor radiotherapy. Conclusion MMP-9, Ki-67, EGFR and VEGF could be used to evaluate the biological behaviors of small intestine adenocarcinoma and MMP-9, Ki-67, EGFR are closely related to the prognosis.