基质金属蛋白酶在淋巴结阴性乳腺癌中的表达及预后价值的研究-外科学(普外)专业论文.docxVIP

安徽医科大学硕士学位论文基质金属蛋白酶在淋巴结阴性乳腺癌中的表达 安徽医科大学硕士学位论文 基质金属蛋白酶在淋巴结阴性乳腺癌中的表达 及预后价值的研究 中文摘要 目的：研究基质金属蛋白酶．2(MMP．2)和基质金属蛋白酶．9(MMP．9)在淋巴 结阴性乳腺癌中的表达及预后价值。方法：对1990～1998年收住手术的270例淋 巴结阴性乳腺癌患者肿瘤标本，用免疫组织化学ABC法检测肿瘤标本基质金属蛋 白酶．2和基质金属蛋白酶．9的表达。进一步分析基质金属蛋白酶的表达与其他临 床病理预后指标如：月经状态、肿瘤大小、病理分级、雌、孕激素受体、病理类 型等相关性。单因素和多因素分析评价基质金属蛋白酶的表达与淋巴结阴性乳腺 癌患者无复发生存率和总生存率的预后意义。结果： 肿瘤标本中MMP．2和 MMP．9的阳性率分别为56．7％(153／270)和59．6％(161／270)，MMP．2和MMP．9 的表达有显著正相关性。MMP．2的阳性表达与肿瘤病理分级、肿瘤大小正相关 (P0．01，P0．05)，而MMP．9的阳性表达仅与肿瘤病理分级正相关(P0．01)。 单因素分析MMP一2阳性、MMP一9阳性及两者共表达患者有较低的无复发生存率 (PO．05)，但和总生存率无关。多因素分析发现MMP。2和MMP一9共表达、肿 瘤大小和肿瘤病理分级能独立预测患者的无复发生存率(PO．05)。结论： 在淋 巴结阴性乳腺癌患者中MMP一2和MMP．9的阳性表达提示患者的预后较差， MMP．2和MMP．9共表达是淋巴结阴性患者独立的预后指标。 关键词：乳腺癌；基质金属蛋白酶；免疫组织化学；淋巴结阴性；预后 安徽医科大学硕士学位论文The 安徽医科大学硕士学位论文 The Expression and Prognostic Value of Matrix Metalloproteinases in Lymph Node—negative Human Breast Carcinoma Abstract objective To study the expression and prognostic value of matrix metalloproteinase一2(MMP-2)and matrix metalloproteinase一9(MMP一9)in lymph node·negative human breast carcinoma． Methods Specimens from the primary tumors of 270 axillary lymph node negative breast cancer patients who underwent surgery between 1990-1998 were studied． MMP·-2 and MMP-·9 protein expression in breast carcinoma samples was performed using lummnohistochemical staining of ABC．The association of MMP-2 and MMP一9 expression with other clini-pathological factors such as menopausal status，tumor size， tumor grade，ER，PR and histotype by chi—square test was analyzed．Univariate and multivariate analysis were performed to evaluate the prognostic significance of MMPs expression in relapse free survival and overall survival in lymph node-negative human breast carcinoma． Results The positive expression of MMP-2 and MMP一9 was 56．7％(1 53／270)and 59．6％(161／270)，respectively．The correlation between MMP-2 and MMP一9 was significance；positive immunostaining of MMP一2 was significantly related to higher tumor grade and larger tumor size(JpO．01．P0．05)：and positive immunostaining of M