乙酰肝素酶、MMP-9在胰腺癌侵袭转移中的表达相关性及临床意义

目的：检测乙酰肝素酶（heparanase,HPA）和基质金属蛋白酶-9（matrix metalloproteinase-9,MMP-9）在胰腺癌、慢性胰腺炎、正常胰腺组织中的表达及相互关系,分析其与临床预后及浸润转移的关系。方法：应用免疫组化SP法检测92例胰腺癌、24例慢性胰腺炎和10例正常胰腺组织中HPA、MMP-9的表达水平,分析两者的表达与临床病理指标的关系,建立Pearson等级相关分析。结果：HPA在胰腺癌中的表达明显高于慢性胰腺炎和正常胰腺组织（77.2%、25.0%、0,P〈0.05）,HPA阳性表达与周围组织浸润、淋巴结转移呈正相关（P〈0.05）,与性别、年龄、组织学分级及1年生存率呈负相关（P〈0.05）;胰腺癌组织中MMP-9表达明显高于慢性胰腺炎和正常胰腺组织（70.7%、20.8%、20.0%,P〈0.05）,且MMP-9阳性表达与周围组织浸润、远处转移呈正相关（P〈0.05）,与性别、年龄、组织学分级及1年生存率呈负相关（P〈0.05）。HPA与MMP-9有较高的共同阳性表达率（P=0.018）。HPA和MMP-9表达呈正相关（r=0.729,P〈0.05）,其共同表达率与肿瘤对周围脏器浸润和淋巴结转移有相关性（P〈0.05）。多因素分析显示,HPA和MMP-9均非影响预后的独立因素。结论：HPA、MMP-9在胰腺癌组织中的表达可能与胰腺癌浸润、转移相关,可作为新的胰腺癌标志物用于联合检测,具有重要的临床意义,且MMP-9可能上调HPA表达水平,促进HPA介导的肿瘤浸润和转移。

HPA and MMP-9 in the expression of invasion and metastasis of pancreatic cancer and clinical significance

Objective：To investigate the expression of heparanase and matrix metalloproteinase-9（MMP-9） ,and their correlations with the metastasis and prognosis of pancreatic carcinoma. Methods：Immunohistochemical staining（SP method） was used to measure HPA and MMP-9 expression in 92 cases of pancreatic carcinoma,24 cases of chronic pancreatitis（CP） and 10 cases of normal pancreas. Correlations of the expression of HPA and MMP-9 to clinicopathologic features were analyzed. Pearson rank correlation was used to analyze. Results：The expression of HPA in pancreatic carcinoma was significantly higher than that in chronic pancreatitis and normal pancreas（77.2%,25.0%,0,P〈0.05） . The HPA protein intensive expression was positively correlated with the infiltration of other tissue and lymph node metastasis（P〈0.05） ,whereas it was negatively correlated with gender,age,histological grade and 1-year postoperative survival（P〈0.05）;the expression of MMP-9 in pancreatic carcinoma was significantly higher than that in chronic pancreatitis and normal pancreas（70.0%,20.8%,20.0%,P〈0.05） . The MMP-9 protein intensive expression was correlated with the infiltration of other tissue and lymph node metastasis（P〈0.05） ,whereas it was negatively correlated with gender,age,tumor differentiation and 1-year postoperative survival（P0.05） . HPA and MMP-9 expression had a higher positive rate in pancreatic carcinoma（P=0.018） . The positive expression of HPA and MMP-9 is correlated in the pancreatic carcinoma（r=0.729,P〈0.05） . Multivariate analysis showed that neither HPA nor MMP-9 was the independent prognostic factor. Conclusion：HPA and MMP-9 may be associated with the infiltration and metastasis of the pancreatic carcinoma. HPA and MMP-9 may be important features of cancer of pancreatic. A combined detection of them may benefit us in prediction of the progression of pancreatic carcinoma. MMP-9 may up-regulate HPA expression and promote HPA-dependent tumor infiltration and metastasis.