基质金属蛋白酶2,9及金属蛋白酶组织抑制剂1在肾盂移行细胞癌中的表达及意义

目的 探讨基质金属蛋白酶2（MMP-2），9（MMP-9）及金属蛋白酶组织抑制剂1（TIMP-1）表达与肾盂移行细胞癌分级、分期及预后的关系。方法 采用免疫组化SP法检测117例肾盂移行细胞癌标本MMP-2，MMP-9发TIMP-1表达水平。患者中男97例，女20例。平均年龄59岁。肿瘤病理分级：G123例、G273例、G321例；TNM病理分期：Ta22例、T127例、T221例、T325例、T422例。结果 肾盂癌组织MMP-2表达阳性率81．2％（95例），MMP-9表达阳性率72．6％（85例），TIMP1表达阳性率72．6％（85例），阳性表达强度和阳性细胞分布不均匀，主要位于肿瘤细胞的胞质，随肿瘤分级、分期增加，MMP-2、MMP-9阳性表达率呈递增趋势，FL与预后相关，差异有统计学意义（P〈0．05）。TIMP-1阳性表达率随分级、分期增加呈递减趋势，但其差异无统计学意义（P〉0．05），TIMP-1表达强度与患者的生存时间无明显相关性。单因素方差分析发现MMP-9／TIMP-1比值与肿瘤临床病理分级、分期密切相关，随着分级、分期增加呈递增趋势（P〈0．05）。结论 MMP-2及MMP-9检测在肾盂癌病理分级、分期中有重要价值。MMP-2、MMP-9及MMP-9／TIMP-1比值在肾盂癌的预后判断中有重要意义。

Expression and significance of matrix metalloproteinase-2,-9 and tissue inhibitor of metalloprotein-ase-1 in transitional cell carcinoma of renal pelvis

Objective To examine the expression of matrix metalloproteinase (MMP)-2,MMP-9 and tissue inhibitor of metalloproteinase (TIMP)-1 of transitional cell carcinoma (TCC) of renal pelvis, and to investigate their correlation with the stage,grade and prognosis. Methods The expression levels of MMP-2,MMP-9 and TIMP-1 in surgical specimens from 117 patients (97 males and 20 females,mean age of 59 years) were examined by immunohistochemical SP method.Pathologic grading showed G_1 tumor in 23 cases,G_2 in 73 and G3 in 21.TNM staging showed T_a tumor in 22 cases,T_1 in 27,T_2 in 21,T_3 in 25 and T_4 in 22. Results The positive rates of MMP-2,MMP-9 and TIMP-1 expression in TCC of renal pelvis was 81.2%(95/117),72.6%(85/117) and 72.6%(85/117),respectively.The intensity of expression and the position of positive expression cells were not well distributed.They were mainly expressed in the cytoplasm of cancer cells.With the increasing of grades and stages,the expression rates of MMP-2 and MMP-9 increased and were correlated with the prognosis.The differences were significant (P< 0.05).With the increasing of grades and stages,the expression rate of TIMP-1 decreased, but the difference was not significance (P> 0.05). There was no correlation between the intensity of TIMP-1 expression and survival period.One-way ANOVA analysis showed that there was a close correlation between the ratio of MMP-9/TIMP-1 and clinical stages and pathologic grades.The ratio of MMP-9/TIMP-1 increased with the increasing of grades and stages (P< 0.05). Conclusions The detection of MMP-2,MMP-9 and TIMP-1 is important in the judgment of the clinical stages and pathologic grades of renal pelvic carcinomas.MMP-2,MMP-9 and the ratio of MMP-9/TIMP-1 are significantly correlated with the prognosis of renal pelvic carcinomas.