国际肿瘤学杂志

国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (3): 177-181.doi: 10.3760/cma.j.issn.1673422X.2015.03.005

• 论著 • 上一篇    下一篇

MMP-9和uPA联合检测对胰腺癌预后的价值 

李诗杰, 胡军红, 谢永铮, 任学群, 贾富鑫, 刘江伟   

  1. 475000 开封，河南大学淮河医院普外科（李诗杰、胡军红、谢永铮、任学群）；郑州大学附属洛阳市中心医院肝胆外科（贾富鑫）；兰州军区乌鲁木齐总医院动物实验科（李诗杰、刘江伟）
  • 出版日期:2015-03-08 发布日期:2015-01-29
  • 通讯作者: 刘江伟，Email: ljw273@sohu.com E-mail:ljw273@sohu.com

The value of combined detection with MMP9 and uPA in prognosis of pancreatic carcinoma

 Li-Shi-Jie, HU  Jun-Hong, XIE  Yong-Zheng, REN  Xue-Qun, JIA  Fu-Xin, LIU  Jiang-Wei   

  1. Department of General Surgery, Henan University Huaihe Hospital, Kaifeng 475000, China
  • Online:2015-03-08 Published:2015-01-29
  • Contact: Liu Jiangwei E-mail:ljw273@sohu.com

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摘要： 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。

关键词: 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

Abstract: ObjectiveTo explore the value of combined detection with MMP9 and uPA in the prognosis of pancreatic carcinoma. MethodsBy 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. ResultsThe 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. ConclusionThey 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.

Key words: Pancreatic neoplasms, Prognosis, Matrix metalloproteinase 9, Urinary plasminogen actirator