MMP-2和TIMP-2在卡介苗治疗膀胱移行细胞癌患者尿液中的含量和临床意义

目的探讨基质金属蛋白酶-2（MMP-2）及相应的组织金属蛋白酶抑制剂-2（TIMP2）在卡介苗治疗膀胱移行细胞癌的表达和临床意义。方法用酶联免疫吸附法（ELISA）定量检测MMP-2及TIMP-2在手术和卡介苗灌注治疗膀胱移行细胞癌患者尿液中的含量，并分析其临床意义。结果经6周治疗后，膀胱移行细胞癌复发率为22．2％。其中预后较好的患者尿液中MMP-2随着时间增加逐渐降低（R^2=0．923，F=59．767，P=0．001），而TIMP-2逐渐增加（R^2=0．926，F=62．338，P=0．001），均与治疗时间有良好的线性回归关系。肿瘤复发患者尿液MMP-2含量跟时间关系符合Cubic模型（R^2=0．978，F=43．653，P=0．006），3周后出现上升趋势，而TIMP-2含量跟时间关系亦符合Cubic模型（R^2=0．997，F=355．060，P〈0．001），5周后出现回落趋势。结论手术联合卡介苗膀胱灌注可有效治疗膀胱移行细胞癌，复发率相对较低，尿液MMP-2与TIMP-2的相对浓度平衡可以作为判断膀胱移行细胞癌恶性程度及预后的生物学指标。

Content of MMP-2 and TIMP-2 in urine of patients with transitional cell carcinoma of bladder treated with bacille calmette guerin

Objective To determine the content of MMP-2 and TIMP2 in the urine of patients with transitional cell carcinoma of bladder treated with surgery and bacille calmette guerin irrigation. Methods The concentration of MMP- 2 and TIMP-2 in the urine of the patients was arrayed by ELISA before and after the therapy, and their clinical significance was analyzed. Results After the 6 week therapy, the recurrence rate of bladder cancer was 22.2%. The concentration of MMP-2 in the urine of patients with better prognosis was increasing, depending on time of treatment （R2=0. 923, F=59. 767, P=0. 001）, but that of TIMP 2 was decreasing, depending on time of treatment （R^2= 0. 926, F= 62. 338, P= 0. 001）, both with linear regression. The concentration of MMP2 in the urine of patients with cancer recurrence had a rising tendency after 3 weeks, consistent with the Cubic model （R^2=0. 978, F=43. 653, P=0. 506）; while the concentration of TIMP-2 in them had a slightly dropping tendency after 5 weeks, consistent with the Cubic model （R^2=0. 997, F=355. 060, P〈0. 001）. Conclusion It is effective to treat transitional cell carcinoma of the bladder with surgery and bacille calmette guerin irrigation, and relatively low recurrence rate. The balance between MMP 2 and TIMP-2 in the urine can be used as an important biomarker for degree of malignancy and prognosis of bladder cancer.