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目的:探讨基质金属蛋白酶-9(matrix metalloproteinase 9,MMP-9)和RECK基因在涎腺多形性腺瘤(pleomorphic adenoma,PA)初发、复发和恶变中的表达及意义。方法:选取新疆医科大学第一附属医院口腔颌面外科2004年至今涎腺PA手术标本58例,其中初发32例,复发6例,恶变9例和11例正常腮腺组织(其中腮腺来源27例,颌下腺来源13例,舌下腺来源2例,小涎腺来源5例)。通过免疫组织化学方法检测RECK、MMP-9在各组标本中的表达,并采用半定量方法进行计量。结果:MMP-9在正常腮腺组织、PA初发、复发及恶变标本中表达呈梯度增高,各组间表达中:正常腮腺组与涎腺PA复发组有显著性差异(P<0.05),正常腮腺组与涎腺CPA组之间有显著性差异(P<0.05),涎腺PA初发组与涎腺CPA组有显著性差异(P<0.05)。RECK在正常腮腺组织、涎腺PA初发、复发及涎腺CPA(恶变)中表达呈梯度降低,并且明显低于正常腮腺组织。各组间表达中:正常腮腺组与涎腺PA初发组有显著性差异(P<0.05),正常腮腺组与涎腺PA复发组有显著性差异(P<0.05),正常腮腺组与涎腺CPA(恶化)组有显著性差异(P<0.05)。在正常腮腺组织、涎腺PA初发、复发和恶变中的表达呈负相关(r=-0.844,P<0.05)。结论:RECK基因与MMP-9在涎腺PA复发、恶变中的表达呈负相关。
Objective: To investigate the expression and significance of matrix metalloproteinase 9 (MMP-9) and RECK gene in primary, recurrence and malignant transformation of pleomorphic adenoma (PA). Methods: From January 2004 to the present, 58 cases of salivary gland PA were collected from the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Xinjiang Medical University. Among them, 32 cases were newly diagnosed, 6 cases were recurrence, 9 cases were malignant and 11 cases were normal parotid gland , 13 cases of submandibular gland origin, 2 cases of sublingual gland origin and 5 cases of small salivary gland origin). The expression of RECK and MMP-9 in each group of specimens was detected by immunohistochemical method and was measured by semi-quantitative method. Results: The expression of MMP-9 in normal parotid gland tissue, PA initial, recurrent and malignant specimens showed a gradient increase. The expression of MMP-9 in normal parotid gland group and salivary gland PA recurrence group was significantly different (P <0.05) There was a significant difference between parotid gland group and salivary gland CPA group (P <0.05). Salivary gland PA group and salivary gland CPA group had significant difference (P <0.05). The expression of RECK in normal parotid gland, salivary gland PA primary, relapse and salivary gland CPA (malignant) showed a gradient decline, and was significantly lower than normal parotid gland tissue. Among the groups, there were significant differences between the normal parotid gland group and the salivary gland PA primary group (P <0.05), the normal parotid gland group and the salivary gland PA recurrence group (P <0.05) The gland CPA (worsening) group had significant difference (P <0.05). In the normal parotid gland tissue, there was a negative correlation between the expression of salivary gland PA in primary, recurrent and malignant lesions (r = -0.844, P <0.05). Conclusion: The expression of RECK gene and MMP-9 in salivary gland PA have a negative correlation with the recurrence and malignant transformation.