两种基质金属蛋白酶在胆脂瘤和中耳癌中的表达

目的探讨基质金属蛋白酶（matrix metalloproteinases, MMP）的MMP-2和MMP-9在胆脂瘤和中耳癌中的表达差异及其在骨浸润作用。方法采用免疫组织化学方法检测36例胆脂瘤上皮，10例胆脂瘤外耳道皮肤、16例中耳癌组织及正常组织中MMP-2和MMP-9的表达。结果①MMP-2和MMP-9在胆脂瘤上皮染色最强。而且在上皮组织的各层细胞均有表达，基底膜染色最强。②胆脂瘤上皮中的MMP-2和MMP-9的表达明显高于其对应的外耳道皮肤和正常外耳道上皮。MMP-2阳性表达在胆脂瘤上皮中为83%，胆脂瘤外耳道上皮为50%，正常外耳道皮肤2例有微弱表达。③16例中耳鳞癌组织中，MMP-9的阳性表达率为50%（8/16），MMP-2的阳性表达率为56.25%（9/16），表达水平与肿瘤的病理分级和临床分期有关。④中耳癌组织中MMP-2的表达与MMP-9表达不一致，而胆脂瘤组织中MMP-2和MMP-9的表达密切相关。结论胆脂瘤向周围骨质侵袭的特性与中耳癌相似，MMPs家族及其抑制剂之间的平衡紊乱所致的蛋白水解酶活性增高是引起中耳胆脂瘤骨吸收的原因之一。

Expression of matrix metalloproteinasa-2,9 in cholesteatoma and middle ear cancer

Objective To study various expressions and roles of MMP 2, 9 in cholesteatoma and middle ear cancer. Methods MMP 2 and MMP 9 were detected with immunohistochemiscal methods using monoclonal antibody in 36 cholesteatomas, 10 CAMS and 16 middle ear cancer. Results The stain in cholesteatoma was stronger than that in CAMS and NAMS. Expressions of MMP 2, 9 were seen in all layers of the epithelium in CA and the stain was strongest in basement membrane. The positive rates of stain was 83% and 50% in CA and CAMS respectively. There was weak stain in 2 NAMS. In middle ear cancer, the expression rates of MMP 9 and MMP 2 were 50%(8/16) and 56.25%(9/16) respectively. The expression level was correlated with tumor differentiation and its clinical stage. Expressions of MMP 2 and MMP 9 were closely related in cholesteatoma. There was no relationship between expressions of MMP 2 and MMP 9 in middle ear cancer. Conclusion Cholesteatoma has a similar feature with middle ear cancer in invading surrounding of surround bone matrix. The disorder between MMPs and its inhibitor was one of reasons for bone absorption of cholesteatoma and middle ear cancer.