NDRG-1及MMP-7在肾细胞癌中的表达及意义

目的研究N-myc 下游调节基因(NDRG-1)和基质金属蛋白酶7（MMP-7）在肾细胞癌组织中的表达，探讨其与肾细胞癌临床病理因素和预后的关系及意义。方法应用免疫组织化学SP法检测78例肾细胞癌组织及相对应的癌旁肾脏组织中NDRG-1、MMP-7表达情况。结果 NDRG-1在正常肾组织和肾细胞癌组织中的表达率分别为100%和52.6%，差异有统计学意义（P<0.05）。NDRG-1表达与肿瘤大小、肾静脉癌栓、肾门淋巴结转移、肾盂浸润、病理组织学分级、临床分期有显著性差异，呈负相关（P<0.05）。MMP-7在肾细胞癌组织中表达率为55.1%，在癌旁肾脏组织中几乎不表达。MMP-7表达与肾细胞癌包膜浸润、淋巴结转移差异有统计学意义(P< 0.05)，并与病理组织学分级、临床分期呈正相关(P< 0.05)。NDRG-1表达阴性和MMP-7表达阳性病例术后生存时间分别显著短于NDRG-1阳性和MMP-7阴性病例（P=0.001）。肾细胞癌组织中NDRG-1和 MMP-7表达无相关性（r_s=-0.198，P=0.082）。结论NDRG-1表达降低和MMP-7升高与肾细胞癌的浸润、转移及生存时间密切相关，NDRG-1和MMP-7可作为早期预测肾细胞癌转移和判断恶性度及预后有意义的指标。

Expression and Significance of NDRG-1 and MMP-7 in Renal Cell Carcinoma

Objective To investigate the expression of N-myc down regulated gene-1(NDRG-1) and matrix metalloproteinase-7(MMP-7) in renal cell carcinoma(RCC),and the relation to clinicopathologic factors and patient prognosis.Methods High sensitive SP immunohistochemistry was used to detect the expressions of NDRG-1 and MMP-7 in 78 cases of renal cell cancer and its adjacent tissues.Results The proportion of NDRG-1-expressing tumor cells(52.6%) was significantly lower than that of normal cells(100%)(P<0.05).The abnormal expression of NDRG-1 correlated with tumor size,renal vein tumor thrombus,metastasis,renal pelvis invasion,histological grade and clinical stage(P<0.05).However,the proportion of MMP-7-expressing tumor cells(55.1%) was significantly higher than that of normal cells(almost no expression).The abnormal expression of MMP-7 correlated with capsular invasion,metastasis,histological grade and clinical stage(P< 0.05).Negative expression of NDRG1 and positive expression of MMP-7 in RCC were strong predictors of poor prognosis respectively(P=0.001).There was no correlation between the expression of NDRG-1 and MMP-7 in RCC(rs=-0.198,P=0.082).Conclusion The low expression of NDRG-1 and high expression of MMP-7 correlate with the invasion,metastasis and patient survival.Our results suggest that NDRG1 and MMP-7 may be two potential targets for determining the degree of malignancy,prognosis and early detection of renal cell carcinoma.