基质金属蛋白酶在卵巢癌腹水中的表达水平及其与肿瘤病理特征的关系

Expression levels of matrix metalloproteinases in ascites of patients with ovarian cancer and the relationship with pathological characteristics of ovarian cancer

目的探讨基质金属蛋白酶-2(MMP-2)和基质金属蛋白酶-9(MMP-9)在卵巢肿瘤腹水中的表达,为卵巢癌腹水的诊断及预后评估提供理论依据。方法对73例卵巢恶性肿瘤患者腹水标本采用酶联免疫吸附法(ELISA)检测MMP-2和MMP-9的水平,同期采用放免法(RIA)检测患者血清中CA125的表达水平。结果 MMP-2和MMP-9在卵巢恶性肿瘤腹水中的水平高于良性肿瘤(t值分别为8.08,10.39,均P<0.01),差异有统计学意义;卵巢恶性肿瘤Ⅲ、Ⅳ期MMP-2与MMP-9水平较Ⅰ、Ⅱ期增高(t值分别为2.75和2.75,均P<0.05),差异有统计学意义;在不同的病理类型、组织学分级、有无淋巴结转移、不同的腹水量及残余灶组中差异无统计学意义(P>0.05);腹水MMP-2和MMP-9检测诊断敏感性(分别为76.0%和88.0%)显著高于腹水细胞学检查(分别为4.61和12.74,均P<0.05),但与血清CA125相比,差异无统计学意义(均P>0.05);腹水MMP-2和MMP-9检测的特异性(分别为78.3%和82.6%)显著低于腹水细胞学检查(分别为5.61和4.38,均P<0.05),但与血清CA125相比,差异没有显著性(分别为1.64和2.68,均P>0.05)。结论腹水中MMP-2和MMP-9水平可能成为鉴别卵巢良恶性病变的标记物,且与卵巢恶性肿瘤患者预后有关。

Objective To explore the expression levels of matrix metalloproteinase-2（ MMP-2） and matrix metalloproteinase-9（ MMP-9） in ascites of patients with ovarian cancer,provide a theoretical basis for diagnosis and prognosis evaluation of ascites of ovarian cancer.Methods ELISA was used to detect the expression levels of MMP-2 and MMP-9 in ascites of 73 patients with ovarian malignant tumor,RIA was used to detect the expression levels of serum CA125.Results The expression levels of MMP-2 and MMP-9 in ascites of patients with ovarian malignant tumor were statistically significantly higher than those in ascites of patients with ovarian benign tumor（ t =8.08,10.39,P〈0.01）.The expression levels of MMP-2 and MMP-9 in patients with ovarian malignant tumor of stage Ⅲ and Ⅳ were statistically significantly higher than those in patients with ovarian malignant tumor of stage Ⅰ and Ⅱ（ t = 2.75,2.75,P 0.05）.There was no statistically significant difference in the expression levels of MMP-2 and MMP-9 among the patients of different pathological types,different histological grades,lymph node metastasis or not,different ascites volumes,and different residual lesions（ P〈0.05）.The sensitivities of MMP-2 and MMP-9 in ascites detection were 76.0% and 88.0%,respectively,which were statistically significantly higher than those of ascites cytological test（ χ~2= 4.61,12.74,P〈0.05）,compared with serum CA125,there was no statistically significant difference（ P〉0.05）.The specificities of MMP-2 and MMP-9 in ascites detection were 78.3% and 82.6%,respectively,which were statistically significantly lower than those of ascites cytological test（ χ~2= 5.61,4.38,P〈0.05）,compaed with serum CA125,there was no statistically significant difference（ χ~2= 1.64,2.68,P〈0.05）.Conclusion MMP-2 and MMP-9 in ascites may be markers for differential diagnosis of ovarian benign tumor and ovarian malignant tumor,which are related to prognosis of patients with malignant ovarian tumor.