MMP-2在滋养细胞肿瘤中的表达及预后相关分析

目的:探讨滋养细胞肿瘤组织中基质金属蛋白酶-2(MMP-2)的表达及其与各临床因素的关系,评价MMP-2在滋养细胞肿瘤预后判断中的价值。方法:应用免疫组化SP法检测侵蚀性葡萄胎32例及绒毛膜癌16例组织中MMP-2的表达情况。根据改良FIGO预后评分标准,小于等于6分为低危组,大于等于7分为高危组,根据手术之前是否接受化疗分为化疗组和未化疗组,回顾性分析MMP-2的表达与各临床因素及预后之间的关系。结果:根据免疫组化染色强度,病例被分为MMP-2高表达组和低表达组,其中MMP-2高表达组37例,低表达组11例。低危组23例其中侵葡18例,绒癌5例。高危组25例,侵葡14例,绒癌11例。MMP-2阳性表达与滋养细胞肿瘤临床分期无相关性(P>0.05);绒毛膜癌高危组强表达率显著高于低危组(P<0.05);侵蚀性葡萄胎、绒毛膜癌组中化疗组MMP-2阳性表达率明显低于未化疗组(P<0.05),化疗组中MMP-2强表达与滋养细胞肿瘤预后评分之间有正相关(P<0.05)。43例随访患者5例复发,高危组复发率16%,低危组复发率4.3%。复发患者均为MMP-2高表达。结论:高表达的MMP-2与肿瘤复发显著相关,MMP-2的检测有望作为滋养细胞肿瘤患者判断预后的有价值的指标。

The relationship between expression of matrix metalloproteinase -2 in trophoblastic tumor and the patients' clinical outcome

Objective:To investigate the relationship between the expression of matrix matalloproteinase-2(MMP-2) in trophoblastic tumor and association with the patients' clinical outcome, to evaluate the prognostic value of MMP-2 expression in trophoblastic tumor. Methods:The expression of MMP-2 in trophoblastic tumor( invasive hydatiform mole 32 cases and choriocarcinoma 16 cases) was detected by immunohistochemical S-P method, 48 cases were divided into high-risk group and low-risk group according to FIGO GTD prognostic rating, the relationship between the expression of MMP-2 and the clinical factors and prognostic outcome was analyzed by using retrospective investigation. Results: All 48 cases were divided into high expression and low expression according to the staining intensity of MMP-2, 37 cases belonged to high group and 11 cases belonged to low group, 23 cases belonged to high-risk group including 18 invasive mole and 5 choriocarcinoma, 25 cases belonged to low-risk group including 14 invasive mole and 11 choriocarcinoma . The expression of MMP-2 was not related to the cilincal stage(P>0.05). The expression of MMP-2 was more found in high-risk cases than in low-risk cases in choriocarcinoma(P<0.05),and positive expression ratio of MMP-2 was less in cases with chemotherapy than without chemotherapy(P<0.05). The expression of MMP-2 in patient treated with chemotherapy was positively associated with prognostic rating(P<0.05), 5 cases were recurrent in 43 followed-up cases and all of recurrent cases were MMP-2 positive expression , recurrent ratio was 16% in high-risk group and 4.3% in low risk group. High expression of MMP-2 was positively associated with the recurrence(P<0.05),5 year survival rate high expression group was significantly lower than the low expression group(P=0.0067) . Conclusion:High expression of MMP-2 is significantly related to the tumor recurrence, MMP-2 might be a valueble prognostic marker for trophoblastic tumor.