目的 探讨基质金属蛋白酶9(matrix metallopmteinase 9,MMP-9)在食管鳞癌中的表达、与临床病理的联系和与生存预后的关系.方法 收集50例有完整临床病理信息和随访记录的手术食管鳞癌标本及其配对癌旁正常组织,胃镜取正常食管粘膜组织30例,采用免疫组化SP法检测MMP-9在组织上的蛋白水平的表达,分析MMP-9的表达与临床病理的联系及与生存时间的关系,并电话随访记录所有患者术后生存情况.结果 (1)免疫组化食管鳞癌、癌旁组织、正常鳞状上皮组织MMP-9的阳性表达率分别为62％(31/50)、18％(9/50)、10％ (3/30);癌组织表达高于癌旁组织(x 2=5.456,P=0.020).(2)MMP-9的表达与患者年龄、性别、肿瘤分化、组织浸润程度无显著相关(P＞0.05),与淋巴结是否转移相关(x2=4.358,P=0.037).(3)生存分析显示:患者生存率随着MMP-9表达水平增高而降低(x 2=4.859,P=0.027).结论 食管鳞癌组织中MMP-9的表达相对较高,与恶性生物学行为的临床病理指标密切相关,且降低患者的预后,检测MMP-9的表达水平对食管癌患者判断病情具有指导意义.%Objective To explore the relationship between expression of matrix metallopmteinase 9 (MMP-9) and clinical pathophysiology,overall survival rate in esophageal squamous cell carcinoma.Methods The expression of MMP-9 protein in specimens taken from 50 cases of esophageal squamous cell carcinoma and paired 50 cases of normal esophageal tissues and 30 cases of normal mucosa were detected by immunohistochemical assay (SP).Analyzed the relationship between these data and clinical pathophysiology,overall survival rate.Investigated patients' postoperative survival by telephone interview.Results The protein positive expression rate in tumor tissues of esophageal squamous cell carcinoma was 62％(31/50),which was higher than 18％(9/50) in adjacent tissues (x 2=5.456,P=0.020).The high expression of MMP-9 protein in esophageal squamous cell carcinoma was related with lymph node metastasis (x 2=4.358,P=0.037),while it had no relationship with sex,age,depth of invasion and degree of differentiation (P＞0.05).There was a significant negative correlation between expression level of MMP-9 and prognosis by Kaplan-Meier survival curve (x 2=4.859,P=0.027).Conclusion MMP-9 expression level was up-regulated in esophageal squamous cell carcinoma and significantly correlated with malignant behavior,and it would reduce prognosis level of patients.Detecting the expression of MMP-9 was useful to evaluate the state of patients with esophageal squamous cell carcinoma.
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