CAJ | 학술논문

目的探讨CXC类趋化因子受体4(CXCR4)和基质金属蛋白酶(MMP)-9在小细胞肺癌(SCLC)中的表达及其与SCLC转移、预后的相关性.方法应用免疫组化方法检测2003年1月至2009年10月在天津医科大学附属肿瘤医院接受手术的65例SCLC患者的组织标本中CXCR4、MMP-9蛋白的表达情况,运用x2检验、生存分析探讨二者表达与SCLC转移、预后的关系.结果 SCLC组织中CXCR4、MMP-9的阳性表达率分别为100.0％ (65/65)和87.7％ (57/65).CXCR4的高表达主要与远处转移中的骨转移有显著的相关性(P =0.004),而与脑转移(P =0.068)及淋巴结转移(P =0.085)无显著相关性；MMP-9的高表达则与患者的术后病理分期相关(P =0.048),与淋巴结转移无显著相关性(P =0.085).单因素生存分析显示,CXCR4表达的高低明显影响SCLC患者的无病生存期(DFS) (P=0.005)；MMP-9表达的高低对SCLC患者的DFS无影响(P =0.341).多因素生存分析显示,CXCR4的表达情况(P =0.015)是影响SCLC患者DFS的独立因素.结论 SCLC组织高表达CXCR4和MMP-9,CXCR4的表达可能与SCLC的骨转移相关；而MMP-9的表达在SCLC转移中的作用不明显.CXCR4的表达情况是影响SCLC患者DFS的独立预后因素.
목적 탐토CXC류추화인자수체4(CXCR4)화기질금속단백매(MMP)-9재소세포폐암(SCLC)중적표체급기여SCLC전이、예후적상관성.방법 응용면역조화방법검측2003년1월지2009년10월재천진의과대학부속종류의원접수수술적65례SCLC환자적조직표본중CXCR4、MMP-9단백적표체정황,운용x2검험、생존분석탐토이자표체여SCLC전이、예후적관계.결과 SCLC조직중CXCR4、MMP-9적양성표체솔분별위100.0％ (65/65)화87.7％ (57/65).CXCR4적고표체주요여원처전이중적골전이유현저적상관성(P =0.004),이여뇌전이(P =0.068)급림파결전이(P =0.085)무현저상관성；MMP-9적고표체칙여환자적술후병리분기상관(P =0.048),여림파결전이무현저상관성(P =0.085).단인소생존분석현시,CXCR4표체적고저명현영향SCLC환자적무병생존기(DFS) (P=0.005)；MMP-9표체적고저대SCLC환자적DFS무영향(P =0.341).다인소생존분석현시,CXCR4적표체정황(P =0.015)시영향SCLC환자DFS적독립인소.결론 SCLC조직고표체CXCR4화MMP-9,CXCR4적표체가능여SCLC적골전이상관；이MMP-9적표체재SCLC전이중적작용불명현.CXCR4적표체정황시영향SCLC환자DFS적독립예후인소.
Objective To explore the expressions of CXC chemokine receptor 4 (CXCR4) and matrix metalloproteinase-9 (MMP-9) and examine their correlations with metastasis,and prognosis in small cell lung cancer (SCLC). Methods Immunohistochemistry was employed to detect the expressions of CXCR4 and MMP-9 in the tissue samples from 65 SCLC patients treated in Cancer Institute and Hospital Attached to Tianjin Medical University from January 2003 to October 2009.And their correlations with metastasis and prognosis were analyzed by Chi-square test and Kaplan-Meier method and Cox regression.Results The positive expression rates of CXCR4 and MMP-9 were 100.0％ (65/65) and 87.7％ (57/65) in SCLC tissues respectively. Significant difference of the expression rate of CXCR4 was found between patients undergoing bone metastasis or not ( P =0.004 ).But the differences were not significant between brain metastasis or not ( P =0.068 ) and lymph node metastasis or not ( P =0.085 ).A high expression rate of MMP-9 was significantly associated with pathological staging ( P =0.048 ).But the difference between lymph node metastasis or not was not significant (P =0.085 ).Univariate analysis suggested that a high expression rate of CXCR4 was significantly correlated with the disease-free survival (DFS) of SCLC patients ( P =0.005).But a high expression rate of MMP-9 was not associated with DFS (P =0.341 ).Multivariate analysis suggested that a high expression rate of CXCR4 was an independent prognostic factor for DFS in SCLC.Conclusions The elevated levels of CXCR4 and MMP-9 are found in SCLC tissues. And the expression rate of CXCR4 may be correlated with bone metastasis,but the correlation is not notable for MMP-9.The expression rate of CXCR4 is an independent prognostic factor for DFS in SCLC.