中下段直肠癌基质金属蛋白酶-2表达与直肠系膜转移的关系

目的分析基质金属蛋白酶-2（MMP-2）在中下段直肠癌的表达及与直肠系膜转移的关系。方法采用病理大切片技术前瞻性研究56例中下段直肠癌直肠系膜转移的情况，免疫组织化学技术检测肿瘤组织MMP-2的表达。结果75％（42／56）的中下段直肠癌MMP-2表达阳性；T2、T3期直肠癌MMP-2表达阳性率分别为69．6％和88．9％，明显高于T1期直肠癌的33．3％（P=0．013）。Ming分型中，浸润型直肠癌MMP-2表达阳性率为91．2％，明显高于膨胀型直肠癌的40．0％（P=0．001）。中下段直肠癌直肠系膜转移率为64．3％（36／56）。系膜转移阳性的36例中有31例（86．1％）MMP-2表达阳性，而系膜转移阴性的20例中仅11例（55．0％）MMP-2表达阳性（P=0．01）。结论中下段直肠癌MMP-2表达与浸润深度和Ming分型密切相关。MMP-2可能参与中下段直肠癌直肠系膜转移的发生。

Matrix metalloproteinase-2 expression and its correlation with mesorectal metastasis in middle and lower rectal cancer

Objective To examine the expression of matrix metalloproteinase-2(MMP-2)and to evaluate its correlation with mesorectal metastasis in middle and lower rectal cancer. Methods The resected primary tumors from 56 patients with middle and lower rectal cancer who received total mesorectal excision were studied from Dec. 2001 to Jul. 2003. Results The MMP-2 expression was positive in 42 (75%) cases. The positive rate of MMP-2 expression was 88.9%in T3 tumors and 69.6%in T2 tumors respectively,while only 33.3%in T1 tumors(P=0.013). MMP-2 was positive in 91.2%(31/34) infiltrative rectal carcinomas while 40.0%(6/15) expansive rectal carcinomas(P=0.001). Mesorectal metastasis was detected in 36(64.3%) of 56 cases. The expression of MMP-2 was positive in 31(86.1%) of the 36 patients with mesorectal metastasis,while in 11(55%) of the 20 patients without mesorectal metastasis (P=0.01). Conclusions The expression of MMP-2 in middle and lower rectal cancer is significantly associated with depth of tumor invasion and Ming classifications. The high expression of MMP-2 may play an important role in the development of mesorectal metastasis in middle and lower rectal cancer.