国际肿瘤学杂志
國際腫瘤學雜誌
국제종류학잡지
JOURNAL OF INTERNATIONAL ONCOLOGY
2015年
3期
177-181
,共5页
李诗杰%胡军红%谢永铮%任学群%贾富鑫%刘江伟
李詩傑%鬍軍紅%謝永錚%任學群%賈富鑫%劉江偉
리시걸%호군홍%사영쟁%임학군%가부흠%류강위
胰腺肿瘤%预后%基质金属蛋白酶9%尿激酶型纤溶酶原激活物
胰腺腫瘤%預後%基質金屬蛋白酶9%尿激酶型纖溶酶原激活物
이선종류%예후%기질금속단백매9%뇨격매형섬용매원격활물
Pancreatic neoplasms%Prognosis%Matrix metalloproteinase 9%Urinary plasminogen acti-rator
目的:探讨基质金属蛋白酶-9(MMP-9)、尿激酶型纤溶酶原激活剂(uPA)二者联合检测在胰腺癌预后判断中的价值。方法采用免疫组织化学二步法检测63例手术切除的原发性胰腺癌组织中MMP-9、uPA的表达,分析二者对预后的价值。结果 MMP-9与uPA的表达呈正相关( r=0.573, P=0.000),MMP-9和uPA表达与胰腺癌的分化程度(r=-0.271,P=0.032;r=-0.333,P=0.008)、TNM分期(r=-0.449,P =0.000;r =-0.430,P =0.000)及淋巴结转移( r =0.329,P =0.009;r =0.400,P=0.001)相关,而 MMP-9与肿瘤大小( r =-0.297,P=0.018,)及远处转移( r=0.320,P =0.011)也存在明显相关性。单因素预后分析结果显示,肿瘤大小(χ2=8.766,P =0.012)、分化程度(χ2=29.050,P=0.000)、临床分期(χ2=24.940,P=0.000)、远处转移(χ2=12.846,P=0.000)、淋巴结转移(χ2=15.457,P=0.000)、MMP-9(χ2=32.700,P=0.000)及uPA(χ2=41.495,P=0.000)与预后密切相关。Kaplan-Meier法生存分析表明,MMP-9阳性表达及阴性表达患者1年累计生存率(χ2=32.700, P=0.000)与uPA阳性表达及阴性表达患者1年累计生存率差异均有统计学意义(χ2=41.495,P=0.000);MMP-9阴性并uPA阴性组患者1年累计生存率(100%)明显高于其他组,差异有统计学意义(χ2=54.892,P=0.000)。多因素分析结果表明,分化程度( RR=2.315,P=0.004)、临床分期( RR=1.694,P=0.002)、MMP-9(RR=0.165,P=0.000)及uPA过表达(RR=0.244,P=0.007)是胰腺癌预后相关的独立影响因子。结论胰腺癌侵袭转移过程中MMP-9和uPA蛋白之间存在某种协同关系,uPA可能通过激活MMP-9加强胶原及弹性蛋白等的降解而促进胰腺癌细胞侵袭和转移,不利于胰腺癌预后。MMP-9和uPA的联合表达模式更准确反映胰腺癌的预后,可以作为分化程度、临床分期判断胰腺癌预后的有益补充。
目的:探討基質金屬蛋白酶-9(MMP-9)、尿激酶型纖溶酶原激活劑(uPA)二者聯閤檢測在胰腺癌預後判斷中的價值。方法採用免疫組織化學二步法檢測63例手術切除的原髮性胰腺癌組織中MMP-9、uPA的錶達,分析二者對預後的價值。結果 MMP-9與uPA的錶達呈正相關( r=0.573, P=0.000),MMP-9和uPA錶達與胰腺癌的分化程度(r=-0.271,P=0.032;r=-0.333,P=0.008)、TNM分期(r=-0.449,P =0.000;r =-0.430,P =0.000)及淋巴結轉移( r =0.329,P =0.009;r =0.400,P=0.001)相關,而 MMP-9與腫瘤大小( r =-0.297,P=0.018,)及遠處轉移( r=0.320,P =0.011)也存在明顯相關性。單因素預後分析結果顯示,腫瘤大小(χ2=8.766,P =0.012)、分化程度(χ2=29.050,P=0.000)、臨床分期(χ2=24.940,P=0.000)、遠處轉移(χ2=12.846,P=0.000)、淋巴結轉移(χ2=15.457,P=0.000)、MMP-9(χ2=32.700,P=0.000)及uPA(χ2=41.495,P=0.000)與預後密切相關。Kaplan-Meier法生存分析錶明,MMP-9暘性錶達及陰性錶達患者1年纍計生存率(χ2=32.700, P=0.000)與uPA暘性錶達及陰性錶達患者1年纍計生存率差異均有統計學意義(χ2=41.495,P=0.000);MMP-9陰性併uPA陰性組患者1年纍計生存率(100%)明顯高于其他組,差異有統計學意義(χ2=54.892,P=0.000)。多因素分析結果錶明,分化程度( RR=2.315,P=0.004)、臨床分期( RR=1.694,P=0.002)、MMP-9(RR=0.165,P=0.000)及uPA過錶達(RR=0.244,P=0.007)是胰腺癌預後相關的獨立影響因子。結論胰腺癌侵襲轉移過程中MMP-9和uPA蛋白之間存在某種協同關繫,uPA可能通過激活MMP-9加彊膠原及彈性蛋白等的降解而促進胰腺癌細胞侵襲和轉移,不利于胰腺癌預後。MMP-9和uPA的聯閤錶達模式更準確反映胰腺癌的預後,可以作為分化程度、臨床分期判斷胰腺癌預後的有益補充。
목적:탐토기질금속단백매-9(MMP-9)、뇨격매형섬용매원격활제(uPA)이자연합검측재이선암예후판단중적개치。방법채용면역조직화학이보법검측63례수술절제적원발성이선암조직중MMP-9、uPA적표체,분석이자대예후적개치。결과 MMP-9여uPA적표체정정상관( r=0.573, P=0.000),MMP-9화uPA표체여이선암적분화정도(r=-0.271,P=0.032;r=-0.333,P=0.008)、TNM분기(r=-0.449,P =0.000;r =-0.430,P =0.000)급림파결전이( r =0.329,P =0.009;r =0.400,P=0.001)상관,이 MMP-9여종류대소( r =-0.297,P=0.018,)급원처전이( r=0.320,P =0.011)야존재명현상관성。단인소예후분석결과현시,종류대소(χ2=8.766,P =0.012)、분화정도(χ2=29.050,P=0.000)、림상분기(χ2=24.940,P=0.000)、원처전이(χ2=12.846,P=0.000)、림파결전이(χ2=15.457,P=0.000)、MMP-9(χ2=32.700,P=0.000)급uPA(χ2=41.495,P=0.000)여예후밀절상관。Kaplan-Meier법생존분석표명,MMP-9양성표체급음성표체환자1년루계생존솔(χ2=32.700, P=0.000)여uPA양성표체급음성표체환자1년루계생존솔차이균유통계학의의(χ2=41.495,P=0.000);MMP-9음성병uPA음성조환자1년루계생존솔(100%)명현고우기타조,차이유통계학의의(χ2=54.892,P=0.000)。다인소분석결과표명,분화정도( RR=2.315,P=0.004)、림상분기( RR=1.694,P=0.002)、MMP-9(RR=0.165,P=0.000)급uPA과표체(RR=0.244,P=0.007)시이선암예후상관적독립영향인자。결론이선암침습전이과정중MMP-9화uPA단백지간존재모충협동관계,uPA가능통과격활MMP-9가강효원급탄성단백등적강해이촉진이선암세포침습화전이,불리우이선암예후。MMP-9화uPA적연합표체모식경준학반영이선암적예후,가이작위분화정도、림상분기판단이선암예후적유익보충。
Objective To explore the value of combined detection with MMP-9 and uPA in the progno-sis of pancreatic carcinoma. Methods By immunohistochemistry PV methods,the expression of MMP-9 and uPA was respectively studied in 63 surgical specimens of primary pancreatic carcinoma and the survival time of patients with pancreatic carcinoma was analysed. Results The expressions of MMP-9 and uPA were positively related(r=0. 573,P=0. 000). The expression of MMP-9 and uPA significantly correlated with differentiation (r= -0. 271,P=0. 032;r= -0. 333,P=0. 008),TNM stages(r= -0. 449,P=0. 000;r= -0. 430,P=0. 000)and lymph node metastasis(r=0. 329,P=0. 009;r=0. 400,P=0. 001),separately. The expression of MMP-9 had also a significant correlation with tumer size(r= -0. 297,P=0. 018)and distant metastasis(r=0. 320,P=0. 011). Univariate analysis identified that tumor size(χ2 =8. 766,P=0. 012),differentiation(χ2 =29. 050,P=0. 000),clinical stage(χ2 =24. 940,P=0. 000),distant metastasis(χ2 =12. 846,P=0. 000), lymph node metastasis(χ2 =15. 457,P=0. 000),MMP-9(χ2 =32. 700,P=0. 000)and uPA(χ2 =41. 495,P=0. 000)were significantly associated with prognosis. Kaplan-Meier survival analysis showed that 1-year survival rate of patients with MMP-9 ( -),uPA ( -)were significantly longer than that of the patients with MMP-9( ﹢),uPA( ﹢),respectively(χ2 =32. 700,P=0. 000;χ2 =41. 495,P=0. 000);1-year survival rate of patients with MMP-9( -)/uPA( -)was significantly longer than the others( Log-rank test,χ2 = 54. 892, P=0. 000). COX regression revealed that differentiation(RR=2. 315,P=0. 004),clinical stage(RR=1. 694, P=0. 002),MMP-9(RR=0. 165,P=0. 000)and uPA(RR=0. 244,P=0. 007)was independent prognostic factors in pancreatic carcinoma. Conclusion They may have a synergistic function in the the process of growth and invasion in pancreatic cancer between MMP-9 and uPA,and the posssible mechanism is that uPA activate degradation of MMP-9,which is not favorable to prognosis. Combined analysis of MMP-9 and uPA may lead to a more reliable prognostic estimation,as the beneficial supplement of the differentiation,and clinical stage to judge the prognosis of pancreatic cancer.