血浆MMP2与TIMP1含量及比值对膀胱癌转移意义_医学论文.docVIP

血浆MMP2与TIMP1含量及比值对膀胱癌转移意义_医学论文 血浆MMP2与TIMP1含量及比值对膀胱癌转移意义_医学论文 【摘要】 目的 探讨血浆基质金属蛋白酶、金属蛋白酶组织抑制因子（TIMP1）的含量及MMP2/TIMP1比值对膀胱癌的诊断价值及其与膀胱癌侵袭转移的关系。方法 采用ELISA法检测76例膀胱移行细胞癌病人和30例健康成人血浆中MMP2、TIMP1的含量。结果 膀胱癌有淋巴结转移组和无转移组血浆中MMP2的含量及MMP2/TIMP1比值均明显高于对照组（H=71.62、16.15，t=2.84～5.14,0.01），TIMP1含量明显低于对照组（H=42.61,t=3.67,0.01）；有淋巴结转移组MMP2的含量高于无淋巴结转移组（t=2.03,0.05）,MMP2/TIMP1比值差异无显著性（Pgt0.05）。结论 血浆MMP2、TIMP1的含量及其比值对膀胱癌的诊断具有重要价值，MMP2含量及MMP2/TIMP1比值可作为膀胱癌侵袭转移的辅助判断指标。 【关键词】 膀胱肿瘤 明胶酶A 酶联免疫吸附试验 ［ABSTRACT］ObjectiveTo assess the diagnostic value of plasma matrix metalloproteinase 2 (MMP2), tissue inhibitor of metalloproteinase 1 (TIMP1) and their ratio in transitional cell carcinoma of bladder and their relation with the invasion and metastasis of the cancer.MethodsThe plasma levels of MMP2 and TIMP1 were detected using sandwich enzymelinked immunosorbent assay (ELISA) in 76 patients and 30 healthy controls. ResultsMMP2 and the ratio of MMP2/TIMP1 were significantly higher in patients than those in the healthy controls (H=71.62,16.15t=2.84-5.140.01), while TIMP1 was significantly lower in the patients (H=42.61, t=3.67, 0.01). The levels of MMP2 were elevated in the metastatic compared with that of the zerometastatic (t=2.03, 0.05). ConclusionThe plasma levels of MMP2, TIMP1 and the ratio of MMP2/TIMP1 are of great importance in the diagnosis of transitional cell carcinoma of bladder. Furthermore, the MMP2 and the ratio of MMP2/TIMP1 may serve also as a supplementary parameter for its metastasis. ［KEY WORDS］ bladder neoplasms gelatinase A enzymeunosorbent assay 膀胱肿瘤是我国泌尿外科最常见的肿瘤，占全部恶性肿瘤的3.2%，其中尿路上皮肿瘤占95%以上。血尿和排尿困难是膀胱肿瘤的常见症状，超声、尿液分析、尿脱落细胞学检查和膀胱镜检查是目前诊断膀胱肿瘤最常用的手段。虽然尿脱落细胞学检查是早期膀胱肿瘤诊断的金标准，但是其敏感度不到30%［1］。膀胱镜检查并活检的敏感度和特异度均大于90%，但它是一种有创性检查［1］，很多病人不能接受。因此，临床需要寻找一种简单、有效的方法来检测膀胱肿瘤。浸润和转移是恶性肿瘤的重要特性，基底膜和细胞外基质（ECM）的降解是细胞浸润的先决条件，基质金属蛋白酶(MMPs)是基质降解过程中最重要的蛋白水解酶,MMPs和其抑制因子（TIMPs）之间的平衡是维护正常结缔组织完整性的重要因素，在恶性肿瘤组织中，这种平衡被打破。目前,大量研究显示,在乳癌、胃癌、肺癌、结直肠癌等组织中MMP2表达水平增高，TIMP1表达水平降低［2,3］，但MMP2、TIMP1在血浆中的含量与膀胱癌的关系研究很少。本研究应