胰头癌组织中基质金属蛋白酶-9的表达及其与预后的关系

Expression of MMP-9 protein in pancreatic head carcinoma and its prognostic significance

目的探讨基质金属蛋白酶-9(matrixmetalloporteinases-9,MMP-9)在胰头癌中的表达及其临床意义。方法选择2000-01~2007-12外科手术切除的胰头癌患者癌组织标本38例(份)、邻近正常的胰腺组织标本11例(份),采用免疫组化法检测MMP-9蛋白在胰头癌组织和邻近正常的胰腺组织中的表达,并分析其与胰头癌患者临床病理特征的关系以及患者的术后的生存率。结果 38例(份)胰头癌中MMP-9的表达率为71.1%(27/38),而11例(份)邻近正常的胰腺组织未见MMP-9表达。MMP-9蛋白表达与肿瘤大小、TNM分期及远处转移有关(P<0.05),而MMP-9蛋白的表达均与患者的性别、年龄、淋巴结是否转移、分化程度无显著相关(P均>0.05)。生存曲线显示,胰头癌患者MMP-9(-)组的生存状况明显好于MMP-9(+)组(P<0.05)。Cox回归分析表明,胰头癌预后的独立危险因素分别为分化程度、TNM分期及MMP-9阳性表达(P均<0.05)。结论胰头癌中MMP-9蛋白表达升高,可能与胰头癌的侵袭、转移密切相关,MMP-9表达升高预示预后差。

Objective To examine the expression of matrix metalloporteinases-9 （MMP-9） protein in pancreat- ic head cancer tissues and to evaluate the correlation of its clinical significance with pancreatic head cancer. Methods From January 2000 to December 2007, the surgical resected cancer tissues and adjacent tissues of 38 patients with pan- creatic head cancer were collected and their clinical data were analyzed. The expression of MMP-9 protein in all the tis- sues was detected by immunohistochemistry, and its relationship with clinicopatholagical features was analyzed. Chi- square test was performed for comparison of rates between the two groups. The overall survival analysis of 38 patients was performed after surgery. Results The expression rate of MMP-9 protein was 71.1% in the pancreatic head cancer tissues（27/38）, and no expression of MMP-9 was found in the adjacent normal pancreatic tissues. The expression of MMP-9 was significantly correlated with tumor size, TNM stages and distant metastasis （P 〈 0. 05）. However, the ex- pression of MMP-9 was not correlated with gender, age, differentiation and lymph node metastasis （P 〉 0. 05）. Kaplan- Meier survival analysis showed that the survival time of the patients with pancreaic head cancer in whom MMP-9 was positively expressed was shorter than that of the patients in whom MMP-9 was negatively expressed（P 〈 0. 05 ）. Cox re- gression showed that differentiation, TNM stages and MMP-9 overexpression were the independent risk factors that were related to the prognosis of pancreatic head cancer（ P 〈 O. 05）. Conclusion MMP-9 is highly expressed in pancreatic head cancer, and may play an important role in the pathogenesis and prognosis of pancreatic head cancer.