瘤内注射重组人p53腺病毒对鼻咽癌组织中基质金属蛋白酶-13表达的影响及意义

Effect and significance of intratumoral injection with recombinant human adenovirus p53 on expression of matrix metalloproteinase-13 in nasopharyngeal carcinoma tissues

目的探讨瘤内注射重组人p53腺病毒注射液(r Ad-p53)对鼻咽癌原发灶组织基质金属蛋白酶(MMP)-13蛋白表达的影响及临床意义。方法将61例确诊中晚期鼻咽癌的患者分为两组。治疗组32例给予r Ad-p53鼻咽部瘤内注射联合同步放化疗;对照组29例给予同步放化疗。收集r Ad-p53瘤内注射前后患者鼻咽部瘤体活组织标本,采用免疫组化检测标本中MMP-13的表达。结果治疗组患者治疗后MMP-13的阳性表达率下降,且存在淋巴结转移的患者MMP-13阳性表达率下降更明显,而对照组患者治疗后MMP-13阳性表达率升高;治疗后治疗组MMP-13的阳性表达率低于对照组(P<0.05)。治疗组和对照组总体生存率比较无明显差异(P>0.05)。结论 r Ad-p53明显影响鼻咽癌原发灶MMP-13蛋白表达,在淋巴结转移患者中更明显,但对总体生存率的影响尚不明确。

Objective To explore the effect and clinical significance of intratumoral injection with recombinant human adenovirus 1053 （rAd-p53） on the expression of matrix metalloproteinase-13 （MMP-13） protein in the primary lesion of nasopharyngeal carcinoma. Methods A total of 61 patients with moderate-stage or advanced nasopharyngeal carcinoma were divided into two groups. Treatment group （n = 32） received intratumoral injection with rAd-p53 and concurrent chemo-radiotherapy. Control group （n = 29 ） received concurrent chemo-radiotherapy alone. The specimens of nasopharyngeal tumor biopsy were collected before and after the intratumoral injection with rAd-p53. And the expression of MMP-13 was detected in the specimens using immumohistochemistry. Results In the treatment group,the positive expression rate of MMP-13 after treatment reduced, and decreased more significantly in the patients with lymph node metastasis. The positive expression rate of MMP-13 after treatment increased in the control group. After treatment ,the positive expression rate of MMP-13 in the treatment group was lower than that in the control group （P 〈 0.05 ）. There was no significant difference in the overall survival rate between treatment group and control group（ P 〉 0.05 ）. Conclusion rAd-p53 can significantly affect the expression of MMP-13 protein in primary lesion of nasopharyngeal carcinoma, especially in patients with lymph node metastasis. But the impact of rAd-p53 on the overall survival rate is not clear.