胃癌患者血清MMP-2、MMP-10、MMP-12表达及临床意义

Expression and clinical significance of serum MMP-2,MMP-10,MMP-12 in patients with gastric cancer

目的分析胃癌患者血清基质金属蛋白酶-2(MMP-2)、MMP-10、MMP-12表达水平及临床意义。方法选取2015年1月—2017年1月辽宁省铁岭市中心医院肿瘤内科诊治的胃癌患者48例作为研究对象(病例组),选取同期医院体检健康者42例作为健康对照组。采用酶联免疫吸附试验(ELISA)检测2组血清MMP-2、MMP-10、MMP-12水平,分析胃癌患者血清MMP-2、MMP-10、MMP-12水平与临床病理参数的相关性,以及不同结局患者血清MMP-2、MMP-10、MMP-12水平的差异,并采用Cox比例风险模型分析胃癌患者预后影响因素。结果病例组患者血清MMP-2、MMP-10、MMP-12水平均高于健康对照组(t=4.809、16.840、14.868,P=0.000)。Ⅰ+Ⅱ期、高/中分化、未见淋巴结转移患者血清MMP-2、MMP-10、MMP-12水平均明显低于Ⅲ+Ⅳ期、低分化、有淋巴结转移者,差异均有统计学意义(t/P=2.462/0.017、2.202/0.033、2.521/0.015;2.703/0.009、3.815/0.000、3.455/0.001;5.006/0.000、8.103/0.000、5.516/0.000)。胃癌患者经3年随访死亡15例,存活33例,死亡者在入院时其血清MMP-2、MMP-10、MMP-12水平均高于存活者(t/P=3.370/0.001、20.143/0.000、7.478/0.000);Cox回归分析显示,淋巴结转移、TNM分期Ⅲ+Ⅳ期、血清MMP-2≥4.25 ng/ml、MMP-10≥1.51 ng/ml、MMP-12≥38.36 ng/ml为影响胃癌患者预后的危险因素(HR=1.667、1.752、1.619、1.397、1.546,P=0.028、0.003、0.007、0.001、0.000)。结论胃癌患者血清MMP-2、MMP-10、MMP-12水平明显增高,且水平越高者预后越差,对胃癌的诊断、预后判断具有一定的意义。

Objective To analyze the expression levels and clinical significance of serum matrix metalloproteinase 2(MMP-2),MMP-10,and MMP-12 in patients with gastric cancer.Methods From January 2015 to January 2017,48 patients with gastric cancer diagnosed and treated in the Department of Oncology,Tieling Central Hospital,Liaoning Province,were selected as the research object(case group),and 42 healthy patients with physical examination in the hospital during the same period were selected as the healthy control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum MMP-2,MMP-10,and MMP-12 in the two groups,and analyze the correlation between serum MMP-2,MMP-10,and MMP-12 levels in gastric cancer patients with clinicopathological parameters,as well as serum MMP in patients with different outcomes 2.The difference between the levels of MMP-10 and MMP-12,and the Cox proportional hazard model was used to analyze the prognostic factors of gastric cancer patients.Results The serum levels of MMP-2,MMP-10,and MMP-12 in the case group were higher than those in the healthy control group(t=4.809,16.840,14.868,P=0.000).The levels of serum MMP-2,MMP-10,and MMP-12 in patients with stageⅠ+Ⅱ,high/moderately differentiated,and no lymph node metastasis were significantly lower than those with stageⅢ+Ⅳ,poorly differentiated,and lymph node metastasis,and the differences were statistically significant(t/P=2.462/0.017,2.202/0.033,2.521/0.015;2.703/0.009,3.815/0.000,3.455/0.001;5.006/0.000,8.103/0.000,5.516/0.000).After 3 years of follow-up,15 patients with gastric cancer died and 33 survived.The serum MMP-2,MMP-10,and MMP-12 levels of the deceased were higher than those of the survivors at the time of admission(t/P=3.370/0.001,20.143/0.000,7.478/0.000).Cox regression analysis showed that lymph node metastasis,TNM stageⅢ+Ⅳ,serum MMP-2≥4.25 ng/ml,MMP-10≥1.51 ng/ml,MMP-12≥38.36 ng/ml were risk factors affecting the prognosis of gastric cancer patients(HR=1.667,1.752,1.619,1.397,1.546,P=0.028,0.003,0.007,0.001,0.000).Conclusion The levels of serum MMP-2,MMP-10,and MMP-12 in patients with gastric cancer are significantly increased,and the higher the level,the worse the prognosis.The detection of serum MMP-2,MMP-10,and MMP-12 has certain significance for the diagnosis and prognosis of gastric cancer.