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目的 :分析肝外胆管癌癌组织去整合素-金属蛋白酶17(ADAM17)、基质金属蛋白酶(MMPs)表达情况及其与患者手术预后的关系。方法 :回顾性分析我院收治的80例肝外胆管癌患者的临床资料,所有患者术中均留取癌组织,采用免疫组化法测定ADAM17、MMPs表达,分析肝外胆管癌癌组织ADAM17、MMPs表达与其手术预后的相关性。结果 :(1)肝外胆管癌患者癌组织ADAM17、MMP-3、MMP-9高表达所占比例均高于癌旁组织;(2)肝外胆管癌患者术后3年、5年生存率为33.75%、22.50%,单因素分析证实:胆管癌位置、肿瘤直径、分化程度、T分期、淋巴结转移、血管及神经侵犯、切缘状态、ADAM17表达、MMP-3表达、MMP-9表达均与患者预后有关;(3)COX多因素分析证实,组织学分级、切缘状态、淋巴结转移、ADAM17表达、MMP-3表达、MMP-9表达均为影响肝外胆管癌患者预后的独立危险因素。结论 :ADAM17、MMP-3、MMP-9高表达均为影响肝外胆管癌患者预后的独立危险因素,其表达水平的变化与肿瘤侵袭、转移、炎症浸润有密切关联。
OBJECTIVE: To analyze the expression of integrin-metalloproteinase 17 (ADAM17) and matrix metalloproteinase (MMPs) in extrahepatic cholangiocarcinoma and its relationship with the prognosis of patients. Methods: The clinical data of 80 patients with extrahepatic cholangiocarcinoma admitted to our hospital were analyzed retrospectively. All the patients were treated with cancer tissue. The expressions of ADAM17 and MMPs were detected by immunohistochemistry. The expressions of ADAM17, Correlation between MMPs expression and surgical outcome. Results: (1) The proportion of high expression of ADAM17, MMP-3 and MMP-9 in patients with extrahepatic cholangiocarcinoma was higher than that in paracancerous tissues. (3) The 3-year and 5-year survival rates of patients with extrahepatic cholangiocarcinoma (33.75%, 22.50%). Univariate analysis confirmed that the location of cholangiocarcinoma, tumor diameter, degree of differentiation, T stage, lymph node metastasis, vascular and nerve invasion, margins, ADAM17 expression, MMP-3 expression and MMP- (3) Cox multivariate analysis confirmed that histological grade, marginal status, lymph node metastasis, ADAM17 expression, MMP-3 expression, MMP-9 expression were independent prognostic factors in patients with extrahepatic bile duct cancer risk factors . Conclusion: The high expression of ADAM17, MMP-3 and MMP-9 are independent risk factors affecting the prognosis of patients with extrahepatic cholangiocarcinoma. The changes of their expression levels are closely related to tumor invasion, metastasis and inflammatory infiltration.