血清基质金属蛋白酶-9、基质金属蛋白酶-2水平对胃癌腹膜转移及预后的预测价值

Predictive value of serum MMP-9 and MMP-2 for peritoneal metastasis and prognosis of gastric cancer

目的:探析血清基质金属蛋白酶-9(MMP-9)和基质金属蛋白酶-2(MMP-2)水平对胃癌腹膜转移及预后的预测价值。方法:选取85例胃癌患者作为研究对象,依照临床诊断中是否腹膜转移分为转移组(n=32)和未转移组(n=53),另选取同期体检的40例健康人士作为对照组,对比三组受检者血清MMP-9和MMP-2表达水平,并分析血清MMP-9和MMP-2与胃癌转移的相关性,应用受试者特征曲线(ROC)分析血清MMP-9和MMP-2对胃癌转移的诊断价值。所有患者均采取胃癌常规手术治疗、放化疗或靶向治疗。治疗后对所有患者进行1年随访,将患者分为预后良好组(n=63)与预后不良组(n=22),对比预后良好组与预后不良组患者一般资料和血清MMP-9和MMP-2表达水平,并应用Logistic回归分析血清MMP-9和MMP-2对胃癌患者预后的预测价值。结果:三组受检者血清MMP-9和MMP-2表达水平对比,转移组明显高于未转移组和对照组(均P<0.05);Spearman相关分析结果显示:血清MMP-9和MMP-2与胃癌转移呈正相关(均P<0.05)。应用ROC曲线分析显示:MMP-9和MMP-2联合诊断的灵敏度与特异度明显高于MMP-9或MMP-2单一诊断(均P<0.05);预后良好组与预后不良组患者性别、年龄、肿瘤位置对比无统计学差异(均P>0.05),两组患者临床分期、腹膜转移、组织分化程度、血清MMP-9与MMP-2表达水平对比差异有统计学意义(均P<0.05);Logistic回归分析结果表明:腹膜转移、血清MMP-9与MMP-2为胃癌患者预后的独立影响因素(均P<0.05)。结论:MMP-9和MMP-2联合对胃癌腹膜转移有较高的诊断价值,且腹膜转移、血清MMP-9与MMP-2为胃癌患者预后的独立影响因素。临床上需针对腹膜转移、血清MMP-9与MMP-2水平升高的患者采取相关措施,减少预后不良情况发生。

Objective:To investigate the predictive value of serum matrix metalloproteinase-9(MMP-9)and matrix metalloproteinase-2(MMP-2)for metastasis and prognosis of gastric cancer.Methods:A total of 85 patients with gastric cancer were divided into metastatic group(32 cases)and non-metastatic group(53 cases)according to whether peritoneal metastase was detected in clinical diagnosis.In addition,40 healthy people at the same time were selected as control group.The serum MMP-9 and MMP-2 expression levels of the three groups were compared and the correlation between serum MMP-9,MMP-2 and gastric cancer metastasis was analyzed.The diagnostic value of serum MMP-9 and MMP-2 for gastric cancer metastasis was analyzed by using ROC curve.All patients were treated with conventional surgery,radiation therapy and chemotherapy or targeted therapy.All patients were followed up one year after treatment and divided into good prognosis group(63 cases)and poor prognosis group(22 cases).General clinical data and serum MMP-9 and MMP-2 expression levels were compared between good prognosis group and poor prognosis group.The prognostic value of serum MMP-9 and MMP-2 for gastric cancer was analyzed by Logistic regression analysis.Results:Serum levels of MMP-9 and MMP-2 in metastatic group were significantly higher than those in other groups(all P<0.05).Spearman correlation analyses showed that serum MMP-9 and MMP-2 were positively correlated with gastric cancer metastasis(P<0.05).ROC curve analysis showed that the sensitivity and specificity of the combined diagnosis of MMP-9 and MMP-2 were significantly higher than that of the single diagnosis of MMP-9 or MMP-2(all P<0.05).There was no significant difference in gender,age and tumor localization between good prognosis group and poor prognosis group(all P>0.05),and there were significant differences in clinical stage,peritoneal metastasis,tissue differentiation,serum MMP-9 and MMP-2 expression levels between two groups(all P<0.05).Logistic regression analysis showed that peritoneal metastasis,serum MMP-9,and MMP-2 were independent influence factors of prognosis in gastric cancer patients(all P<0.05).Conclusion:The combination of MMP-9 and MMP-2 has a high diagnostic value for peritoneal metastasis in gastric cancer.Peritoneal metastasis,serum MMP-9 and MMP-2 are independent influence factors of prognosis in gastric cancer patients.In clinical practice,relevant measures should be taken to reduce adverse prognosis in patients with peritoneal metastasis and elevated serum MMP-9 and MMP-2 levels.