MMP-9和COX-2蛋白的表达对胰腺癌预后的影响  

Prognostic value of the expressions of MMP-9 and COX-2 in pancreatic carcinoma

作　　者：贾富鑫[1] 刘江伟[1] 张东[1] 李鹏[1] 李建英[2] 冯玉玲[1] 冯德元[1] 

机构地区：[1]兰州军区乌鲁木齐总医院肝胆外科 [2]兰州军区乌鲁木齐总医院实验动物中心

出　　处：《中华临床医师杂志（电子版）》2011年第7期1917-1922,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：中国博士后科学基金第48批面上资助项目(20100481517)

摘　　要：目的探讨MMP-9和COX-2蛋白在胰腺癌组织中的表达及其对患者预后的影响。方法应用免疫组化二步法检测63例手术切除的原发性胰腺癌组织中MMP-9和COX-2蛋白的表达情况,分析MMP-9、COX-2的阳性表达与患者预后的关系。结果 (1)MMP-9和COX-2蛋白的阳性表达率分别为68.3%和73%,MMP-9和COX-2蛋白的表达之间有明显相关性(P=0.000,r=0.430)。(2)Kaplan-Meier法描绘生存曲线分析表明,MMP-9蛋白阳性组患者中位生存时间(9个月)明显较阴性组(18个月)短,差异有统计学意义(P=0.000);COX-2蛋白阳性组患者中位生存时间(10个月)明显较阴性组(36个月)短,亦有统计学差异(P=0.000)。MMP-9阴性/COX-2阴性组患者(9例)1年累计生存率(92.3%)明显高于其他组。(3)Cox比例风险模型(χ2=54.122,P=0.000)多因素分析表明:分化程度(P=0.000)、淋巴结转移(P=0.000)、MMP-9过表达(P=0.000)及COX-2过表达(P=0.024)为影响胰腺癌预后的独立因素。结论胰腺癌组织中存在MMP-9、COX-2的高表达,且两者之间的表达强度具有等级相关性,其高表达提示患者预后不良。联合检测MMP-9、COX-2表达可作为预测胰腺癌发生转移的危险性及患者预后情况。Objective To study the expression of MMP-9 and COX-2 in pancreatic cancer cell and its prognostic significance. Methods The expressions of MMP-9 and COX-2 were examined in 63 surgical specimens of primary pancreatic carcinoma with immunohistochemistry PV methods,Correlation of these expressions and prognosis of pancreatic cancer was analyzed. Results (1)Positive immunostaining for MMP-9 and COX-2 was observed in 68.3% and 73% of the pancreatic cancer samples respectively.The positive expressions of MMP-9 and COX-2 were significantly correlated in pancreatic cancer(P=0.000,r=0.430).(2)Kaplan-Meier survival analysis showed that The median survival(9 months) of 63 patients with MMP-9(+) was significantly shorter than the median survival (18 months) of the patients with MMP-9(-)(Log-rank test,χ2=32.700,P=0.000).The median survival(10 months) of 63 patients with COX-2(+) was significantly shorter than the median survival (36 months) of the patients with COX-2(-)(Log-rank test,χ2=21.964,P=0.000).1-year survival(92.3%) of 9 cases with MMP-9(-)/COX-2(-)cases was significantly longer than the median survival of other cases.(3)Cox regression model analysis suggested:The differentiation(P=0.000),lymph node metastasis(P=0.000),MMP-9 (+)expression(P=0.000) and COX-2 (+)expression(=0.024)were independent prognostic factors for pancreatic cancer. Conclusions This study showed that MMP-9 and COX-2 were highly expressed in pancreatic cancer cell,MMP-9 expression was positive correlation with COX-2 expression,which indicated that the overexpression of MMP-9and COX-2 maybe poor prognostic predictors for pancreatic cancer patients.They may be potential indicators of metastasis and predictors for prognosis of pancreatic cancer.

关 键 词：胰腺肿瘤 基质金属蛋白酶9 环氧化酶2 免疫组织化学 预后 

分 类 号：R735.9[医药卫生—肿瘤]