Ⅳ型胶原和基质金属蛋白酶-2、-9在胆囊癌血管生成拟态组织中的表达与意义.pdfVIP

· 1472· Q 生! 箜丝鲞箜 塑 垦翌 瑾 !!! 竺 24 ：! · 胆 道 外 科 · Ⅳ型胶原和基质金属蛋白酶．2、．9在 胆囊癌血管生成拟态组织中的表达 与意义 孙伟 范跃祖 张文忠 葛春艳 【摘要】 目的 探讨Ⅳ型胶原和基质金属蛋白酶．2(MMP2)、MMP9在胆囊癌血管生成拟态 (VM)中的表达与意义。方法 74例胆囊癌、胆囊腺瘤和慢性胆囊炎各10例病理标本及资料，应 用免疫组织化学Envision、SABC法测定上述病变组织Ⅳ型胶原和MMP2、MMP9表达，Kaplan．Meier 生存曲线和Cox风险模型分析其与胆囊癌VM的相关性和临床意义。结果 (1)在VM(+)胆囊 癌，Ⅳ型胶原表达明显低于、MMP2表达明显高于VM(一)胆囊癌(P0．01)，MMP9则无差异。 (2)Ⅳ型胶原与VM(+)胆囊癌分化程度负相关；MMP2、MMP9与VM(+)胆囊癌的Nevin晚期、侵 犯浆膜、肝转移正相关，MMP2尚与VM(+)胆囊癌的低分化和淋巴结转移正相关。(3)Ⅳ型胶原 阳性和MMP2、MMP9阴性VM(+)胆囊癌患者术后5年生存期明显短于VM(一)胆囊癌(P 0．01；P0．05；P0．01)，MMP2阳性VM(+)胆囊癌患者术后5年生存期亦明显短于VM(一)胆 囊癌。VM、1V型胶原是影响胆囊癌患者预后的独立因素。结论 Ⅳ型胶原、MMP2分别与胆囊癌 VM呈负、正相关，MMP9与胆囊癌VM无关；IV型胶原和MMP2可作为判断胆囊癌是否存在VM及 VM胆囊癌预后的重要指标。 【关键词】 胆囊肿瘤；血管生成拟态； IV型胶原；基质金属蛋白酶-2、-9； 预后 Expremion of coHagenⅣand matrix metalloproteinase-2，-9 in human primary gallbladder carci· noma s m vasculogenic mimicry and its significance sUN Wet，FAN Yue·m，zHANG Wen·zhong et a1．Department ofSurgery， Hospitd of rong~University，Shanghai 200065，China Corresponding author： NY~e-gu 【Abstract】 Objective To investigate the expression of collagen IV and matrix metalloproteinase· 2(MMP2)，-9(MMP9)in human primary gallbladder carcinomas with vaseulogenie mimicry(VM)and its significance．Methods Seventy．four carcinomas．10 adenomas and 10 chronic inflammatory lesions of the gallbladder confirmed histopathologieally and their clinica1．．patMogical data were studied and~llowed uD．Envision method and streptavidin—biotin eomplex method of immunohistoehemistry were used to deter— mine the expression of collagenⅣ．MMP2 and MMP9 proteins in each paraffin section of every patient in vivo．Kaplan—Meier actuarial survival curves and Cox multiple factors were used to analyze the correlation among the expression of collagenⅣ．MMP2 and MMP9 proteins and the gallbladder carcin