免疫组化检测明胶酶在喉鳞状细胞癌组织中的表达及其临床意义

Immunohistochemistry to Detect the Expression and Clinical Significance of MMP-2 and MMP-9 in Squamous Cell Carcinoma of Larynx

目的:探讨明胶酶(MMP-2和MMP-9)在喉鳞状细胞癌组织中的表达及其临床意义。方法:应用免疫组化方法检测72例喉鳞状细胞癌组织标本中MMP-2和MMP-9蛋白的表达,并与临床病理特征和预后进行对比。结果:72例喉鳞状细胞癌中MMP-2和MMP-9的阳性表达率分别为50.0%(36/72)和73.6%(53/72)。MMP-2和MMP-9的表达与肿瘤的进展相关,其中T1+T2与T3+T4中的阳性表达率分别为2.9%(1/35)、24.3%(9/37)和25.7%(9/35)、48.6%(18/37),有显著差异(P=0.008,P=0.045)。MMP-2的表达与临床分期亦存在显著相关,Ⅰ+Ⅱ期和Ⅲ+Ⅳ期的阳性表达率分别为3.1%和22.5%,晚期喉鳞状细胞癌MMP-2的表达显著增强。MMP-2和MMP-9蛋白的强阳性表达也是预后不良的指标。MMP-2表达阴性/弱阳性和强阳性患者的5年生存率分别为62.9%(39/62)和20.0%(2/10),表达强阳性者其生存率显著降低(P=0.0040);MMP-9表达阴性/弱阳性和强阳性患者的5年生存率分别为64.4%(29/45)和44.4%(12/27),MMP-9的强阳性表达亦引起喉鳞状细胞癌生存率下降,经LogRank检验P=0.0553,统计学有显著差异。结论:喉鳞状细胞癌中存在MMP-2和MMP-9蛋白的表达,其表达与喉鳞状细胞癌的进展显著相关,两者的表达可能是喉鳞状细胞癌预后不良的指标。

Objective: To investigate the expression and clinical significance of gelatinases (MMP-2 and MMP-9) in tissue samples of laryngeal squamous cell carcinoma (LSCC). Methods: Immunohistochemistry was used to examine the expression of MMP-2 and MMP-9 in tissue samples of 72 LSCCs and the results were compared to clinical pathological features and prognosis. Results: The positive expression of MMP-2 and MMP-9 in 72 LSCCs was 50.0%(36/72) and 73.6% (53/72) respectively. Their expression had the relationship with cancer advancement. Their positive expression in T1+T2 and T3+T4 was 2.9%(1/35), 24.3%(9/37)and 25.7%(9/35), 48.6%(18/37)respectively, which had significant difference (P=0.008, P=0.045). The positive expression rate of MMP-2 in stage Ⅰ+Ⅱ and Ⅲ+Ⅳ was 3.1% and 22.5% respectively. There was significant relationship between the expression of MMP-2 and clinical stage. The expression of MMP-2 was more evident in advanced LSCCs. The strong expression of MMP-2 and MMP-9 was also a marker for poor prognosis in LSCC. The 5-year survival rate was 62.9% (39/62) and 20.0% (2/10) in negative/weak positive and strong positive expression of MMP-2 respectively. Strong expression of MMP-2 decreased survival significantly (P=0.0040). The 5-year survival rate was 64.4% (29/45) and 44.4% (12/27) in negative/weak positive and strong positive expression of MMP-9 respectively. The strong expression of MMP-9 also influenced the survival, but Log Rank test only showed marginal significance (P=0.0553). Conclusion: There is the expression of MMP-2 and MMP-9 in LSCC, which has the significant relationship with tumor advancement and is a potential marker for poor prognosis of LSCC.