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目的探讨上皮性卵巢癌中癌相关成纤维细胞(CAFs)与临床病理特征间的相关性。方法应用免疫组化通用型二步法检测145例上皮性卵巢癌中平滑肌肌动蛋白(α-SMA)和基质金属蛋白酶-9(MMP-9)的表达,并分析两者的相关性及其临床意义。结果 (1)正常卵巢组织除卵巢间质血管外,α-SMA不表达。在145例上皮性卵巢癌中,α-SMA阳性的CAFs细胞在癌组织中的分布有3种方式;且Ⅲ~Ⅳ期卵巢癌间质α-SMA阳性表达强度明显高于Ⅰ~Ⅱ期(P=0.016);有淋巴结转移的卵巢癌明显高于无淋巴结转移卵巢癌(P=0.049)。(2)正常卵巢组织中MMP-9不表达;而上皮性癌中癌细胞MMP-9阳性率为95.2%(138/145)。MMP-9在Ⅲ~Ⅳ期组明显高于Ⅰ~Ⅱ期组(P=0.028),有淋巴结转移组强阳性率高于无转移组(P=0.033)。(3)α-SMA在上皮性卵巢癌间质强阳性表达与癌细胞MMP-9的表达呈正相关(P=0.027)。结论α-SMA和MMP-9两者的共同强阳性表达主要集中于Ⅲ~Ⅳ期癌患者和有淋巴结转移的患者中,CAFs的存在与数量增多将成为上皮性卵巢癌预后不良的一项独立指标。
Objective To investigate the correlation between the expression of cancer associated fibroblasts (CAFs) and clinicopathological features in epithelial ovarian cancer. Methods The expression of α-SMA and MMP-9 in 145 cases of epithelial ovarian cancer was detected by immunohistochemistry and two-step method. The correlation between them Clinical significance. Results (1) α-SMA was not expressed in normal ovarian tissues except ovarian stromal vessels. In 145 cases of epithelial ovarian cancer, α-SMA positive CAFs cells in cancer tissue distribution in three ways; and Ⅲ ~ Ⅳ ovarian stromal α-SMA positive expression was significantly higher than Ⅰ ~ Ⅱ ( P = 0.016). Ovarian cancer with lymph node metastasis was significantly higher than that without lymph node metastasis (P = 0.049). (2) MMP-9 is not expressed in normal ovarian tissues; while the positive rate of MMP-9 in epithelial carcinoma is 95.2% (138/145). The positive rate of MMP-9 in group Ⅲ ~ Ⅳ was significantly higher than that in group Ⅰ ~ Ⅱ (P = 0.028). The positive rate of MMP-9 in group with lymph node metastasis was higher than that in group without metastasis (P = 0.033). (3) There was a positive correlation between the positive expression of α-SMA and the expression of MMP-9 in epithelial ovarian cancer (P = 0.027). Conclusions The positive expression of both α-SMA and MMP-9 is mainly concentrated in patients with stage Ⅲ-Ⅳ carcinoma and patients with lymph node metastasis. The presence and quantity of CAFs will become an independent prognostic factor for epithelial ovarian cancer index.