Influence of preoperative core biopsies on uPA/PAI-1 expression in breast cancer tissue

The urokinase-type plasminogen activator (uPA) and the plasminogen activator inhibitor-1 (PAI-1) are involved in tumor invasion and metastasis as well as wound healing and inflammation. We investigated the impact of tissue injury by preoperative sampling on the level of uPA/PAI-1 in paraffin tissue of 55 breast cancer cases by immunohistochemistry. The tumor area surrounding the biopsy channel was compared with distant intact tumor tissue. uPA and PAI-1 were constantly expressed by the tumor cells. Fibroblastic expression was higher in the tumor area surrounding the biopsy channel than in intact tissue with 47 vs 29 positive cases for uPA (p<0.001) and 35 vs 25 positive cases for PAI-1 (p=0.055). A decrease in fibroblastic enzyme expression from the biopsy area to the intact tumor tissue was seen in 21 cases for uPA and 16 cases for PAI-1. This difference was most evident in cases with an interval of 6 days and longer between biopsy and surgery. In conclusion, fibroblastic inflammatory reaction around the biopsy channel affects stromal uPA and PAI-1 expression, which possibly leads to falsely increased enzyme levels in ELISA. Tissue specimen for ELISA analysis should not be taken from the tumor area around the biopsy channel in the resection specimen.     

Matrix metalloproteinases and tissue inhibitors of metalloproteinases in joint fluid of the patients with loose artificial hip joints.

The pseudojoint cavity formed in patients undergoing total hip arthroplasty (THA) is later remodeled to synovial membrane-like tissue, which produces pseudosynovial fluid. This pseudosynovium also is an important source of matrix metalloproteinases (MMPs). As it is widely speculated that synovial fluid MMPs may contribute to local tissue degradation in rheumatoid arthritis (RA) and osteoarthritis (OA), we hypothesize that locally produced MMPs are found in the pseudosynovial fluid, via which they have access to the implant-host interface, and that if they retain their proteolytic potential, they might contribute to aseptic loosening. Enzyme-linked immunosorbent assay (ELISA), immunoblotting, and zymography were used to analyze MMPs and tissue inhibitors of metalloproteinases (TIMPs) in synovial fluid in aseptic loosening, which was compared to RA and OA. Pseudosynovial THA fluid was characterized using low levels of MMP-1 but moderate levels of MMP-13 and MT1-MMP (MMP-14). Due to the lack of an appropriate assay, MMP-13 and MT1-MMP were not similarly assessed, but the immunoblotting indicated that they were in the 56 kD intermediate proteolytically processed forms. The MMP-9 level was intermediate between RA and OA. MMP-2 was on a significant level, but there were no differences among study groups. The THA group also was characterized using relatively high levels of TIMP-1 and TIMP-2. Accordingly, MMP-9 and MMP-2 were found to occur in the 92 kD and 72 kD proenzyme form, respectively, with full activity retained in all study groups. The data suggest that proMMP-2-TIMP-2 and proMMP-9-TIMP-1 complexes are formed in the pseudosynovial fluid due to the excess of TIMPs over MMPs in aseptic loosening of THA. TIMP-complexed MMPs are resistant to MMP-mediated proteolytic activation, which may explain their latency and proenzyme zymogen form. Thus, formation of stabilizing proMMP-TIMP complexes enable transportation of proMMPs far from their original site of production. Due to motion-associated cyclic changes of the intra-articular pressure, fluid-phase MMPs stabilized by TIMPs might be absorbed to implant surfaces and interface tissues and help to dissect the implant/cement-to-bone interface in situ. Consequently, they may contribute to local proteolytic/tissue destructive events and aseptic loosening.     

胃癌中uPA、PAI-1表达及其与血管生成的关系

目的 观察胃癌组织中uPA、PAI-1mRNA及蛋白的表达，并探讨它们与肿瘤分化、血管生成及临床病理因素之间的关系。方法 用原位杂交及免疫组化S-P法检测110例胃癌组织中uPA、PAI-1的表达，根据CD34阳性的血管内皮细胞计数肿瘤组织微血管密度（MVD）。结果 （1）胃癌组织中uPA mRNA和蛋白、PAI-1 mRNA和蛋白阳性表达定位于胞质；uPA的表达随分化程度的降低有逐渐升高的趋势，PAI-1的表达随分化程度的降低有逐渐降低的趋势。（2）110例uPA mRNA及蛋白表达阳性组MVD值显著高于阴性组，差异均具有显著性（P值均＜0．05）。（3）uPA mRNA及蛋白的表达与临床分期呈正相关（P＜0．05），PAI-1的表达与临床分期和淋巴结转移无相关性。（4）uPA mRNA／蛋白与PAI-1 mRNA／蛋白的表达无相关性。结论uPA与促进胃癌的血管生成密切相关，阻断uPA的分泌和作用途径有望对胃癌浸润转移起抑制作用；胃癌组织中PAI-1可能担当重要的调节剂或者是肿瘤细胞防止自身降解的保护剂而不是这个系统的单纯抑制剂。     

In situ localization of mRNA for the fibrinolytic factors uPA, PAI-1 and uPAR in endometriotic and endometrial tissue

Endometriotic tissue grows invasively. The plasminogen-activating system is suggested to participate in degradation of extracellular matrix (ECM) and modulation of cell adhesion and migration. We have previously demonstrated elevated levels of the fibrinolytic factors urokinase plasminogen activator (uPA) and plasminogen activator inhibitor (PAI-1) in endometriotic tissue and endometrium from women with endometriosis. The aim of the present study was to localize the uPA, PAI-1 and urokinase plasminogen activator receptor (uPAR) mRNA in endometriotic tissue and in endometrium both from women with and without endometriosis. With in situ hybridization, we found that uPA mRNA seems to be up-regulated in endometriotic glands and endometrial stroma as well as PAI-1 mRNA in endometriotic and endometrial stroma from women with endometriosis. uPAR mRNA likewise appears to be up-regulated in both glands and stroma in endometriotic tissue and in endometrial glands from patients compared to endometrial glands and stroma from healthy women. These differences might be important for menstrual shedding and adherence of endometrial fragments to peritoneal lining in women developing endometriosis and for the invasive growth of endometriotic tissue.     

Immunohistochemical expression of uPA, uPAR, and PAI-1 in breast carcinoma. Fibroblastic expression has strong associations with tumor pathology

The urokinase-type plasminogen activator (uPA) system has been implicated in tumor spread. We have used immunohistochemistry to examine three components of this system, ie, uPA, uPA receptor (uPAR), and plasminogen activator inhibitor-1 (PAI-1), in a pilot study on 142 cases of breast carcinoma. We wished to determine whether there were any relationships between expression of the proteins in either tumor cells or fibroblasts and clinical and pathological features. Strong uPA expression in each cell type was significantly related to high tumor grade (P = 0.013 and 0.008, respectively), and was more common in invasive than in in situ carcinomas (P < 0.0001). Fibroblastic expression of uPAR was only related to the presence of invasion (P < 0.0001). Strong PAI-1 expression in both cell types was seen in high-grade tumors (tumor cells, P = 0.012; fibroblasts, P < 0.001), but only fibroblastic expression was related to the presence of invasion (P = 0.042). Fibroblastic expression of both uPA and uPAR were positively correlated with tumor size. Although patients with strong fibroblastic expression of uPA showed a tendency toward a shorter time to relapse, none of the plasminogen activator proteins were significantly associated with relapse-free survival. These results suggest that strong expression of uPA, uPAR, and PAI-1 in fibroblasts rather than in tumor cells have the most impact on the clinical behavior of breast cancer. Larger prospective studies are needed to confirm these findings.     

怀牛膝对骨关节炎模型膝关节滑膜组织中基质金属蛋白酶-3、13和金属蛋白酶组织抑制剂-1的影响

目的:观察怀牛膝对骨关节炎(OA)模型膝关节滑膜组织中基质金属蛋白酶-3、13(MMP-3、MMP-13),金属蛋白酶组织抑制剂(TIMP-1)表达的影响,探讨其对骨关节炎的作用机制。方法:新西兰大白兔随机分为正常组、模型组、怀牛膝治疗组、西乐葆对照组,其中治疗组分为怀牛膝高剂量、中剂量和低剂量3组。参照Hulth造模法制作实验性兔膝关节骨关节炎模型。造模1周后开始给药,连续治疗6周后取材,剪下滑膜组织,运用免疫印迹法分别检测滑膜组织中MMP--3、MMP-13、TIMP-1表达,通过图像分析系统比较各组之间差异。结果:病灶侧滑膜组织中MMP-3、MMP-13灰度比值在怀牛膝高、中剂量组以及西乐葆对照组与模型组分别比较差异明显,而怀牛膝高、中剂量组与西乐葆对照组比较无差异。TIMP-1灰度比值在怀牛膝高、中剂量组和西乐葆对照组与模型组比较差异均差异明显,而怀牛膝高、中剂量组分别与西乐葆对照组比较也存在差异。怀牛膝低剂量组MMP-3、MMP-13和TIMP-1灰度比值与模型组比较无差异。结论:怀牛膝治疗骨关节炎可能是通过抑制MMP-3和MMP-13的表达以及增加TIMP-1表达来实现的。     

LPS对新生大鼠肺组织MMP-2和t-PA,PAI-1表达影响的研究

目的制备新生大鼠肺损伤模型,探讨MMP-2和t-PA, PAI-1mRNA在新生大鼠肺损伤中的作用.方法腹腔注射LPS致新生大鼠肺损伤的病理改变,应用免疫组化和RT-PCR的方法分别检测肺组织MMP-2蛋白和t-PA, PAI-1 mRNA的表达改变.结果病理改变证实了新生大鼠肺出血的发生,注射LPS后8h,MMP-2蛋白表达达高峰(P<0.01),差异显著.t-PA mRNA表达高峰为给药后2h(P<0.01),之后表达逐渐下降.PAI-1 mRNA表达高峰为给药后2h至8h(P<0.01).结论用LPS制备了新生大鼠肺出血(1种严重的肺损伤)的动物模型,肺组织t-PA表达的增加可能导致MMP-2的降解作用明显增加,PAI-1表达的增加使局部肺组织处于1种高凝状态,可能导致肺出血的发生.     

多囊卵巢综合征患者血PAI-1和uPA含量的变化

目的观察多囊卵巢综合征(PCOS)患者外周血纤溶酶原激活抑制物1(PAI-1)和尿激酶型纤溶酶原激活物(uPA)的水平。方法实验分PCOS组和对照组,PCOS组又分为肥胖组和正常体重组,用酶联免疫吸附法(ELISA)测定PCOS组与对照组患者血浆PAI-1及血清uPA水平,并测定体重指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、空腹胰岛素及胰岛素释放试验(IRT),以稳态模型公式评估胰岛素抵抗(IR),并计算胰岛素曲线下面积(AUC)。结果PCOS组与对照组相比,黄体生成素/卵泡刺激素(LH/FSH)、睾酮(T)、空腹血糖、稳态(HOMA)指数、AUC及PAI-1含量均显著升高(P<0.05)。其中,PCOS肥胖组与正常体重组相比,HOMA指数、AUC及PAI-1含量也显著升高(P<0.05)。在相关性分析中,PAI-1与HOMA指数、PAI-1与AUC、PAI-1与BMI、HOMA-IR与BMI均有显著相关性(P<0.0001)。结论胰岛素抵抗和肥胖是影响PCOS患者PAI-1水平升高的一个很重要因素,抗PAI-1的研究可能为多囊卵巢综合征的治疗提供一个新的方法。     

The correlation of RANK, RANKL and TNFalpha expression with bone loss volume and polyethylene wear debris around hip implants

This study investigates receptor activator NF-kappaB (RANK), RANK ligand (RANKL) and tumour necrosis factor (TNFalpha), key factors regulating bone turnover, present in the tissues near peri-prosthetic osteolysis. Tissue was obtained from zones of peri-prosthetic osteolysis from 11 patients undergoing revision of total hip prostheses, analysed preoperatively by high-resolution spiral multislice CT using a metal artefact suppression protocol. Synovial tissue from 10 patients with osteoarthritis undergoing primary hip replacement was used as control tissue. Immunohistochemical analysis of formalin fixed tissue sections demonstrated that RANK, RANKL and TNFalpha were strongly expressed by large multinucleated cells containing polyethylene wear debris in revision tissues. Control tissue stained weakly for RANK, RANKL and TNFalpha. A strong statistical correlation (p<0.02) was found between the five parameters, volume of bone loss, polyethylene wear debris, RANK, RANKL and TNFalpha expression. Importantly, in vitro studies revealed that RANKL and TNFalpha synergise to increase the volume of bone resorbed, by more than seven fold, when compared to the effect of either cytokine treatment alone. This suggests that the interaction of TNFalpha and RANKL promotes osteoclast activity associated with polyethylene wear and therapies targeting TNF activity may be useful to treat peri-implant osteolysis.     

uPA和PAI-1在人脑胶质瘤的表达及其与肿瘤血管生成的关系

目的探讨uPA、PAI鄄1和VEGF与人脑胶质瘤病理分级和侵袭行为的关系及各因子间的相互联系。方法采用免疫组化SP方法检测42例人脑胶质瘤和8例正常脑组织uPA、PAI鄄1和VEGF蛋白的表达。结果12例中低度恶性胶质瘤中,uPA、PAI鄄1和VEGF阳性表达率分别为58.3%、50.0%、33.3%,30例高度恶性胶质瘤的阳性率分别为96.7%、86.7%、93.3%,两组间各指标相比较,uPA和VEGF差异有极显著性(P<0.01),PAl鄄1差异有显著性(P<0.05)。uPA、PAI鄄1和VEGF阳性染色主要定位于血管内皮细胞和瘤细胞胞浆,以肿瘤侵袭边缘和坏死组织周围多见。uPA与VEGF、PAI鄄1与VEGF之间均呈明显正相关(P<0.05)。8例正常脑组织除1例有PAl鄄1微弱表达外,其余均为阴性。结论随脑胶质瘤恶性度增高,uPA、PAl鄄1和VEGF表达增强,三者协同作用,可作为胶质瘤恶性度高和侵袭能力强潜在的分子生物学指标。     

Prognostic relevance of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitors PAI-1 and PAI-2 in gastric cancer

Expression of urokinase-type plasminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1) and plasminogen activator inhibitor-2 (PAI-2) was evaluated in 125 surgically resected gastric cancers by immunohistochemical analysis. Tissue was stained immunohistochemically with a monoclonal antibody against human uPA and monoclonal antibodies against human PAI-1 and PAI-2. In addition, DNA ploidy patterns were determined by cytofluorometer after staining with propidium iodide. We found that 82 (66%) of the 125 gastric cancers expressed uPA as diffuse cytoplasmic staining, as intensely outlined luminal borders. PAI-1 expression was observed in 62 (50%) of 125 gastric cancer as a fine, diffuse and granular pattern in the cytoplasm. PAI-2 expression was observed in 65 (52%) of the 125 gastric cancers as a diffuse cytoplasmic staining. uPA-positive tumours showed a higher incidence of infiltration, lymph node metastasis and peritoneal dissemination than uPA-negative ones. Patients with uPA-positive tumours proved to have a significantly poorer prognosis than those with negative ones. PAI-1-negative tumours showed a higher incidence of liver metastasis and carried a poorer prognosis than PAI-1-positive ones. There was no significant correlation between uPA or PAI-1 expression and DNA ploidy patterns. Conversely, there was no significant relationship between PAI-2 expression and clinicopathological parameters and prognosis. According to the expression of uPA and PAI-1 status, groups of 19 uPA(–)/PAI-1(–), 44 uPA(+)/PAI-1(–), 23 uPA(–)/PAI-1(+) and 39 uPA(+)/PAI-1(+) were subdivided. Tumours with UPA(+)/PAI-1(–) had a significantly higher incidence of liver metastasis, lymph node metastasis and serosal invasion than the other groups of tumours. Patients with uPA(+)/PAI-1(–) tumours had a significantly poorer prognosis than those with uPA(–)/PAI-1(+) tumours. These results indicate that uPA expression is a useful biological prognostic indicator, and that uPA and PAI-1 may play an important part in the tumour progression and metastasis in gastric cancer.     

Expression and Roles of MMP-2, MMP-9, MMP-13, TIMP-1, and TIMP-2 in Allergic Nasal Mucosa

Purpose

Allergic rhinitis (AR) and asthma share many characteristics, but structural changes are observed far less often in AR. Matrix metalloproteinases (MMPs) constitute a family of Zn-dependent endopeptidases that can decompose the extracellular matrix and basement membrane, and regulate cell infiltration. We analyzed the expression of MMPs and their inhibitors, tissue inhibitors of metalloproteinases (TIMPs), in allergic nasal mucosa after nasal allergen challenge (NAC) and determined their relationship to inflammatory cells.

Methods

Nasal mucosa specimens were obtained at surgery performed for hypertrophied turbinates. We performed NAC with house dust mite (HDM) allergen disks and control disks, and took biopsies at 30 minutes, 6 hours, and 12 hours after NAC. Cells expressing MMP-2, MMP-9, MMP-13, TIMP-1, and TIMP-2, as well as eosinophils and mast cells, were analyzed immunohistochemically. The MMPs and TIMPs in allergic nasal mucosa were quantified using enzyme-linked immunosorbent assays.

Results

At 30 minutes post-NAC, HDM-exposed nasal mucosa exhibited significantly more MMP-2+, MMP-9+, MMP-13+, TIMP-1+, and TIMP-2+ cells compared with control mucosa, and the numbers of MMP-9+ and TIMP-1+ cells correlated strongly with the number of mast cells. At 6 hours post-NAC, the numbers of MMP+ and TIMP+ cells did not differ significantly between HDM-exposed mucosa and control mucosa, but the ratios of MMP+ cells to TIMP+ cells were higher in HDM-exposed mucosa. At 12 hours post-NAC, the number of MMP-13+ cells tended to be higher in HDM-exposed mucosa and was strongly correlated with the number of eosinophils. Quantitatively, the levels of MMP-2 and MMP-13 were significantly higher than the MMP-9 level, and the TIMP-2 level was significantly higher than the TIMP-1 level in allergic nasal mucosa.

Conclusions

We demonstrated increased expression of MMP-2, MMP-9, and MMP-13 in allergic nasal mucosa, high MMPs-to-TIMP-1 ratios, and a strong correlation between MMP-9 and mast cells and between MMP-13 and eosinophils. The imbalance between MMPs and TIMPs may contribute to the migration of inflammatory cells such as eosinophils and mast cells to the nasal mucosa of AR patients, suggesting a possible active role of MMPs in AR.     

Matrix metalloproteinases MMP-7, MMP-9 and their tissue inhibitor TIMP-1: expression in chronic sinusitis vs nasal polyposis

BACKGROUND: Nasal polyps (NP) are characterized by pseudocyst formation, whereas the mucosa in chronic sinusitis (CS) only shows a limited oedema. Matrix metalloproteinases (MMPs) are a family of endopeptidases able to degrade the extracellular matrix. Differences in histological features between CS and NP might be related to the respective expression of MMPs and their tissue inhibitors (TIMPs). OBJECTIVE: The aim of this study was to investigate MMP-7, MMP-9 and TIMP-1 proteins in NP and CS in comparison with normal mucosa. METHODS: Nasal samples, obtained from controls (n = 10), from NP (n = 8) and from CS (n = 10), were analysed by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA). RESULTS: In NP, compared with controls, staining for MMP-9 and MMP-7 appeared in blood vessels. Matrix metalloproteinase-9-positive inflammatory cells could be detected in increased numbers in pseudocyst formations. Concentrations of MMP-9 protein was found significantly increased in both CS and NP compared with controls, while MMP-7 was significantly increased in NP compared with controls and CS. Tissue inhibitors of metalloproteinase-1 protein was significantly increased in CS and NP when compared with controls. CONCLUSIONS: Chronic sinusitis and NP show different pattern of MMP-7/-9 and TIMP-1 expression. We suggest that this difference in regulation of enzymes is related to the respective tissue remodelling observed in both diseases.     

Quantitative analysis of mRNA expression of TIMPs in the periprosthetic interface tissue of loose hips by real-time PCR system.

Matrix metalloproteinases (MMPs) and their endogenous inhibitors, tissue inhibitors of metalloproteinases (TIMPs), have been reported to play a critical role in extracellular degradation around artificial hip joints. Although messenger ribonucleic acid (mRNA) expression patterns of several MMPs and TIMPs were reported, there is no report of quantitative mRNA analysis of TIMPs in periprosthetic tissues. In this study, mRNA expression of four different types of TIMPs in periprosthetic interface tissue of loose hips was analyzed by a quantitative polymerase chain reaction system. The mRNA expression level of TIMP-1, -2, and -3 in periprosthetic interface tissue was significantly higher than that in control. In contrast, the mRNA expression level of TIMP-4 in the periprosthetic interface tissue was lower. This study suggested that increased levels of TIMP-1, -2, and -3, and decreased levels of TIMP-4 may contribute to pathologic extracellular matrix degradation in combination with MMPs, thus leading to prosthetic loosening and osteolysis around artificial total hip joints.     

创伤性关节炎软骨中基质金属蛋白酶13及组织特异性抑制剂1的表达*

背景：关节软骨损伤后继发性退变机制仍不十分清楚。近年研究发现关节软骨细胞外基质合成与降解失衡是造成软骨变性的重要原因之一,其中基质金属蛋白酶可能起决定性的作用。 目的：观察基质金属蛋白酶13及其组织特异性抑制剂1在创伤性关节炎中的表达及与软骨退变的关系。 方法：将新西兰兔分别用骨水泥制作的模具从1.33 kg,46 cm高度和0.43 kg,20 cm高度进行自由落体撞击制备轻型和重型撞击创伤性关节炎兔模型。 结果与结论：苏木精-伊红染色和免疫组织化学染色结果显示,基质金属蛋白酶13和组织特异性抑制剂1在两组均增高(P < 0.05)。组织特异性抑制剂1在重型撞击创伤性关节炎模型兔软骨组织中的分泌明显高于轻型撞击组(P < 0.05)。说明关节软骨在创伤后,基质金属蛋白酶13及组织特异性抑制剂1表达上调,共同作用促进了关节软骨退变,其中组织特异性抑制剂1的过量表达可能是造成关节软骨进一步损害的原因之一。     

Differential localization and expression of urokinase plasminogen activator (uPA), its receptor (uPAR), and its inhibitor (PAI-1) mRNA and protein in endometrial tissue during the menstrual cycle

Normal endometrium is a highly dynamic tissue, which responds to ovarian steroids with cyclic proliferation, differentiation (secretion), and degradation (menstruation). The urokinase plasminogen activator (uPA)-dependent proteolytic cascade as well as ligand activation of the uPA receptor (uPAR) is critically involved in physiological as well as pathophysiological aspects of tissue expansion and remodelling. Cyclic variation and distribution of uPA, uPAR and plasminogen activator inhibitor 1 (PAI-1) mRNA were examined by in situ hybridization, real-time PCR and northern blot in normal endometrium. Their corresponding proteins were localized with immunohistochemistry. uPA mRNA is exclusively expressed by stromal cells, whereas uPA protein is present in both epithelial and stromal cells. Immunostaining for uPA protein is reduced or undetectable at midcycle, thus coinciding with peak concentration of uPA in the uterine fluid. uPAR mRNA is expressed by epithelial cells in the proliferative phase and by stromal cells in the secretory phase. However, epithelial cells stain for uPAR protein throughout the cycle, suggesting that uPAR may detach from stromal cells and then bind to epithelial cells in the secretory phase. PAI-1 mRNA is located in vessel walls. The late secretory phase has greatly increased expression of all three mRNA and their proteins, mainly in pre-decidual cells in the superficial stroma. Discordant localization of the mRNA and proteins suggest that uPA is produced by stromal cells, released and bound to epithelial cells in both the proliferative and secretory phases, whereas uPAR is released from the stroma and bound to epithelial cells in the secretory phase. Also, the present data together with earlier reports suggest that uPA is released from the epithelial cells to the uterine fluid.     

应用组织芯片研究基质金属蛋白酶-13在 乳腺癌中的表达及其临床意义

目的：探讨基质金属蛋白酶-13（matrix metalloproteinase-13, MMP-13）在乳腺癌发生、发展过程中的临床意义。方法：应用组织芯片技术和免疫组织化学SP法检测MMP-13在97例乳腺癌和39例乳腺纤维腺瘤中的表达情况,并分析其与临床病理参数的关系。结果：乳腺癌中MMP-13的表达（65.98%）显著高于乳腺纤维腺瘤（23.08%）,其表达与腋窝淋巴结转移、临床分期有关,而与患者年龄、肿瘤大小无关。结论：MMP-13与乳腺癌的发生、发展有着密切关系,可作为评估乳腺癌转移和预后的重要生物学指标。