视网膜母细胞瘤PAX6、Ki-67和MMP-9的表达及其与组织病理学的关系

Expression of PAX6,Ki-67 and MMP-9 and their relationship with clinical histopathological features in retinoblastoma

目的检测PAX6、Ki-67及MMP-9在视网膜母细胞瘤(RB)中的表达,探讨其与RB临床组织病理学特征之间的关系及临床意义。设计实验性研究。研究对象石蜡包埋RB组织40例,其中<3岁组27例,≥3岁组13例。方法采用免疫组织化学Elivision法检测PAX6、Ki-67及MMP-9在40例RB组织中的表达情况,分析该3种蛋白表达与患者性别、眼别、年龄、视神经受侵情况以及是否化疗等临床组织病理学特征的关系,并分析3种蛋白表达之间的相关性。主要指标RB组织中PAX6、Ki-67、MMP-9的表达及临床组织病理学特征。结果 40例RB组织中,PAX6、Ki-67及MMP-9的阳性表达率分别为52.5%、55.0%、57.5%。Ki-67在年龄大于3岁组的阳性表达率高于年龄小于3岁组(χ2=6.825,P=0.016),PAX6(χ2=0.631,P=0.511)及MMP-9(χ2=0.129,P=1.000)的表达与年龄无显著相关性。3种蛋白的表达均与性别及眼别无显著相关性。PAX6、Ki-67及MMP-9在球后视神经受侵袭组的阳性表达率均高于未受侵袭组(χ2=14.401,P=0.017;χ2=11.831,P=0.046;χ2=13.961,P=0.038)。PAX6及Ki-67在未化疗组的阳性表达率均高于化疗组(χ2=8.120,P=0.010;χ2=6.465,P=0.025)。PAX6和Ki-67的表达呈正相关(r=0.347,P=0.028)。结论 PAX6的高表达促进了RB细胞的增生;PAX6、Ki-67和MMP-9的高表达与RB的侵袭有一定的相关性;化疗对RB中PAX6和Ki-67的表达有一定的抑制作用,在一定程度上可以降低RB侵袭转移的风险。

Objective To investigate the expression of PAX6, Ki-67 and MMP-9 in retinoblastoma （RB） cells and to evaluate their relationship with clinical histopathological characteristics as well as their clinical significance. Design Experimental study. Participants 40 cases of paraffin-embedded RB tissues. Methods The expression of PAX6, Ki-67 and MMP-9 in paraffin-embedded RB tissues was detected by immunohistochemistry. The relationship between these expressions and clinical histopathological characteristics was analyzed. The inter correlation between these expressions was analyzed as well. Main Outcome Measures The expression of PAX6, Ki-67 and MMP-9 in RB tissue; the clinical and histopathological features. Results The positive expression rates of PAX6, Ki-67 and MMP-9 in RB tissue were 52.5%, 55.0%, 57.5%, respectively. The expression of Ki-67 in the 3-year or older age group was significantly higher than that in the age 〈3 year group （χ^2=6.825, P=0.016）, but no significant differences were found in the expression of PAX6 （χ^2=0.631, P=0.511） or MMP-9 （χ^2=0.129, P=1.000） between different age groups. Meanwhile, no significant differences were found in the expressions of all three proteins between different genders or laterality groups. The expression of PAX6 （P=0.017）, Ki-67 （P=0.046） and MMP-9 （P=0.038） in the retrolaminar optic nerve infiltrated group were all significantly higher than the retrolaminar optic nerve non-infiltrated group. The expression of PAX6 （χ^2=8.120, P=0.010） and Ki-67 （χ^2=6.465,P=0.025） protein in the non-preoperative chemotherapy group were significantly higher than the preoperative chemotherapy group. The expression of PAX6 was significantly correlated with Ki-67 （r=0.347, P=0.028）. Conclusion The high expression of PAX6 promotes the proliferation of retinoblastoma cells. The overexpression of PAX6, Ki-67 and MMP-9 may contribute to the invasion of retinoblastoma together. Chemotherapy inhibits the expression of PAX6 and Ki-67 in retinoblastoma, reducing the risk of invasion and metastasis to some degree.