肝外胆管癌组织MMP-2表达及其临床意义

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目的 MMP-2是基质金属蛋白酶(matrixmetalloproteinase,MMPs)家族中最主要的家族成员,因其可以降解细胞外基质,使癌细胞能够顺利穿透细胞外基质和基底膜组成的屏障,浸润其临近的纤维结缔组织,进而发生远处转移。本研究探讨MMP-2在肝外胆管癌及正常胆管组织中的表达水平及其临床意义。方法收集济宁医学院附属湖西医院2005-11-01-2010-04-30肝外胆管癌手术切除蜡块标本共61例为研究对象,选取同期胆管正常组织标本35例作为对照。采用免疫组化方法检测61例肝外胆管癌及35例胆管正常组织中MMP-2蛋白的表达情况,统计分析MMP-2蛋白和患者临床病理特征及预后相关性。结果肝外胆管癌组中MMP-2阳性表达率73.77%(45/61),显著高于胆管正常组织的5.71%(2/35),差异有统计学意义,P<0.001。不同性别、年龄、肿瘤分化程度、淋巴结转移和TNM分期肝外胆管癌组织中MMP-2表达水平差异有统计学意义,均P值<0.05。MMP-2阴性肝外胆管癌患者术后1、3和5年生存率分别为82.00%、55.00%和25.00%,MMP-2阳性肝外胆管癌患者术后1、3和5年生存率分别为33.00%、9.00%和0,两组生存率差异有统计学意义,χ~2=16.556,P<0.001。结论 MMP-2的表达与肝外胆管癌发生、发展和浸润转移相关,可能在肝外胆管癌的浸润转移中发挥重要作用。MMP-2有望成为新的肝外胆管癌的肿瘤标志物,为预后判断和制定相应的治疗方案提供依据。 Objective MMP-2 is the most important family member of the matrix metalloproteinase (MMPs) family. Because it can degrade the extracellular matrix, the cancer cells can penetrate the barrier composed of extracellular matrix and basement membrane infiltration, Fiber connective tissue, and further distant metastasis. This study was to investigate the expression of MMP-2 in extrahepatic cholangiocarcinoma and normal bile duct tissue and its clinical significance. Methods Totally 61 cases of paraffin - embedded specimens of extrahepatic cholangiocarcinoma were collected from Huxi Hospital Affiliated to Jining Medical College. 35 cases of bile duct normal tissue specimens were selected as the control. Immunohistochemistry was used to detect the expression of MMP-2 in 61 cases of extrahepatic cholangiocarcinoma and 35 cases of bile duct normal tissues. The clinicopathological characteristics and prognosis of MMP-2 protein were analyzed statistically. Results The positive expression rate of MMP-2 in extrahepatic cholangiocarcinoma group was 73.77% (45/61), which was significantly higher than that in bile duct normal group (5.71%, 2/35), the difference was statistically significant (P <0.001). There was significant difference in the expression of MMP-2 between different sex, age, tumor differentiation, lymph node metastasis and TNM staging of extrahepatic cholangiocarcinoma (P <0.05). The 1,3-and 5-year survival rates of patients with MMP-2-negative extrahepatic cholangiocarcinoma were 82.00%, 55.00% and 25.00%, respectively. The 1,3 and 5-year survival rates of patients with MMP-2-positive extrahepatic cholangiocarcinoma 33.00%, 9.00% and 0 respectively. There was significant difference in survival rate between the two groups (χ ~ 2 = 16.556, P <0.001). Conclusions The expression of MMP-2 is associated with the occurrence, development, invasion and metastasis of extrahepatic cholangiocarcinoma and may play an important role in the invasion and metastasis of extrahepatic cholangiocarcinoma. MMP-2 is expected to become a new tumor marker of extrahepatic cholangiocarcinoma, provide a basis for prognosis and formulate the appropriate treatment options.
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