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目的:探讨MMP-7与子宫内膜癌发病及转移的关系。方法:利用免疫组化的方法观察72例子宫内膜癌病变组织、64例内膜癌前病变组织和80例正常子宫内膜中MMP-7及其天然抑制物TIMP-1的表达情况。结果:在内膜癌组、内膜癌前病变组MMP-7的阳性表达分别为87.5%(63/72)、75%(48/64),明显高于正常内膜组43.8%(35/80)(P<0.01),而两组之间无显著差异。内膜癌组和癌前病变组TIMP-1的阳性表达分别为80.6%(58/72)、65.6%(42/64),也明显高于正常内膜组38.8%(31/80)(P<0.01)。随着内膜癌临床分期的增加,MMP-7的表达明显增强,Ⅱ期以上的内膜癌MMP-7表达均明显高于Ⅰ期(P<0.05)。在不同组织学分类中,组织分化程度低的内膜癌MMP-7表达明显高于组织分化程度高者。淋巴结转移阳性的内膜癌组织,MMP-7表达高于淋巴结转移阴性的内膜癌组织(P<0.01)。而TIMP-1则与上述病理学参数无显著相关性。结论:MMP-7在内膜癌发生过程中起到了重要作用,MMP-7表达增强和TIMP-1分泌相对不足,是内膜癌浸润和转移的重要促进因素。
Objective: To investigate the relationship between MMP-7 and the pathogenesis and metastasis of endometrial carcinoma. Methods: The expressions of MMP-7 and its natural inhibitor TIMP-1 in 72 cases of endometrial cancer, 64 cases of endometrial precancerous lesions and 80 cases of normal endometrium were observed by immunohistochemistry. Results: The positive expression of MMP-7 in endometrial carcinoma and endometrial precancerous lesions was 87.5% (63/72) and 75% (48/64) respectively, which was significantly higher than that in normal endometrium (43.8% vs 35.8% 80) (P <0.01), but no significant difference between the two groups. The positive expression rates of TIMP-1 in endometrial carcinoma and precancerous lesions were 80.6% (58/72) and 65.6% (42/64), respectively, which were significantly higher than those in normal endometrium (38.8%, P <0.01). With the increase of clinical stage of endometrial carcinoma, the expression of MMP-7 was significantly increased, and the expression of MMP-7 in stage II and above was significantly higher than that in stage I (P <0.05). In different histological classification, the expression of MMP-7 in the tissue with low degree of differentiation was significantly higher than that in the tissue with high degree of differentiation. The positive expression rate of MMP-7 in the endometrial carcinoma with lymph node metastasis was higher than that in the endometrial carcinoma with lymph node metastasis (P <0.01). TIMP-1 was not significantly correlated with the above pathological parameters. Conclusion: MMP-7 plays an important role in the carcinogenesis of endometrial carcinoma. The increased expression of MMP-7 and the relative lack of secretion of TIMP-1 are important factors for the invasion and metastasis of endometrial carcinoma.