膜型基质金属蛋白酶-1在乳腺癌中表达的预后价值  

Prognostic significance of MT1-MMP expression in breast cancer

作　　者：姚广裕[1,2] 何萍[3] 王曦[1] 唐军[1] 罗荣城[2] 叶长生[2] 王军业[1] 戎铁华[1] 杨名添[1] 

机构地区：[1]中山大学附属肿瘤医院华南肿瘤学国家重点实验室,广州510060 [2]南方医科大学南方医院,广州510515 [3]广州医学院第一附属医院病理科,广州510120

出　　处：《中华乳腺病杂志（电子版）》2009年第1期14-18,共5页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：国家"十五"科技攻关计划资助项目(2001BA703B04)

摘　　要：目的探讨膜型基质金属蛋白酶-1(MT1-MMP)蛋白在乳腺癌中表达的临床意义。方法采用免疫组织化学方法检测106例乳腺癌患者手术标本中MT1-MMP蛋白的表达;用统计学软件SPSS11.0作为统计分析的工具,MT1-MMP表达与临床病理因子的关系用卡方检验和Pearson等级相关分析检验;预后分析采用Kaplan-Meier检验CoxRe-gression。结果乳腺癌组织中MT1-MMP蛋白表达阳性率为62.3%,表达强度在不同分期和不同淋巴结转移数目患者间差异有统计学意义且呈正相关(P<0.050),在不同大小肿瘤间及在ER、PR和HER-2不同表达的患者间差异无统计学意义。MT1-MMP阴性患者与弱至中度阳性或强阳性患者间的无病生存期比较,MT1-MMP(-)为65.0%,MT1-MMP(+～■)为27.1%,MT1-MMP(■)为27.8%,差异有统计学意义(P<0.050)。不同MT1-MMP免疫组织化学染色强度患者的7年生存率也明显不同,MT1-MMP(-)为77.5%,MT1-MMP(+～)为60.4%,MT1-MMP()为50.0%,差异有统计学意义(P<0.050)。根据不同分期和不同淋巴结转移状态分层分析发现,MT1-MMP蛋白不同表达强度的患者预后差异有统计学意义(P<0.050);根据不同肿瘤大小的分层分析发现,不同MT1-MMP表达强度的T2期和T4期患者预后差别有统计学意义(P<0.050),但T1和T3期患者预后没有差别。多因素分析显示MT1-MMP是有意义的预后因子,MT1-MMP强阳性患者死亡风险增加2倍,弱到中度阳性患者死亡风险增加1.3倍。结论MT1-MMP的表达与乳腺癌侵袭转移有关,MT1-MMP是乳腺癌的预后因子。Objective To explore the clinical significance of MT1-MMP expression in breast cancer. Methods The MT1-MMP protein expression was detected in human breast cancer specimens from 106 patients by immunohistochemistry assay. Statistical analysis was performed using SPSS 11.0 statistical software. The correlation between MT1-MMP expression and other pathological variables in breast cancer was determined by the Chi-square test and Spearman rank correlation test. The Kaplan-Meier method and the Cox proportional hazard model were used for survival analysis. Results The expression of MT1-MMP protein was found in 62.3% of the breast samples. There was a positive correlation between advanced stage or lymph node involvement and MT1-MMP positivity（P 〈0.050）. No correlation was found between MT1-MMP immunoreactivity and tumor size, HER-2, estrogen or progesterone receptor status. The 7-year disease-free survival was remarkably different between patients with MT1-MMP negative tumors （65.0%） and with MT1-MMP weakly or moderately positive tumors （27.1% ） or highly positive tumors （27.8%） （P 〈 0.050）. The 7-year overall survival was significantly different in patients with different MT1-MMP expressions： MT1-MMP（ - ） was 77.5% ; MT1-MMP （ ＋ -＋＋） was 60.4%; and MT1-MMP （＋＋＋） was 50.0%, with statistically significant difference （P 〈 0.050）. MT1-MMP positivity correlated significantly with shortened survival in patients with different lymphonode involvement and stage. The mortality rate was different in the patient groups with stage T2 and Y4, but identieal in the patient groups with T1 and T3. A multivariate analysis showed that MT1-MMP positivity in eaneer eells maintained its association with a poor outcome. The relative risk increased by 1.3 times in the patients with weak or moderate positivity and by 2 times in the patients with highly positive tumors. Conclusion The expression of MT1-MMP is correlated with breast cancer aggression and metastasis. MT1-MMP expression in brea

关 键 词：膜型基质金属蛋白酶-1 乳腺肿瘤 预后 

分 类 号：R737.9[医药卫生—肿瘤]