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目的探讨基质金属蛋白酶2(MMP2),9(MMP9)及金属蛋白酶组织抑制剂1(TIMP1)表达与肾盂移行细胞癌分级、分期及预后的关系。方法采用免疫组化SP法检测117例肾盂移行细胞癌标本MMP2,MMP9及TIMP1表达水平。患者中男97例,女20例。平均年龄59岁。肿瘤病理分级:G123例、G273例、G321例;TNM病理分期:Ta22例、T127例、T221例、T325例、T422例。结果肾盂癌组织MMP2表达阳性率81.2%(95例),MMP9表达阳性率72.6%(85例),TIMP1表达阳性率72.6%(85例),阳性表达强度和阳性细胞分布不均匀,主要位于肿瘤细胞的胞质,随肿瘤分级、分期增加,MMP2、MMP9阳性表达率呈递增趋势,且与预后相关,差异有统计学意义(P<0.05)。TIMP1阳性表达率随分级、分期增加呈递减趋势,但其差异无统计学意义(P>0.05),TIMP1表达强度与患者的生存时间无明显相关性。单因素方差分析发现MMP9/TIMP1比值与肿瘤临床病理分级、分期密切相关,随着分级、分期增加呈递增趋势(P<0.05)。结论MMP2及MMP9检测在肾盂癌病理分级、分期中有重要价值。MMP2、MMP9及MMP9/TIMP1比值在肾盂癌的预后判断中有重要意义。
Objective To investigate the relationship between the expression of MMP2, TIMP1 and the grade, stage and prognosis of renal pelvis transitional cell carcinoma. Methods Immunohistochemical SP method was used to detect the expression of MMP2, MMP9 and TIMP1 in 117 cases of renal pelvis transitional cell carcinoma. There were 97 males and 20 females. The average age is 59 years old. Tumor pathological grading: G123 cases, G273 cases, G321 cases; TNM pathological stage: Ta22 cases, T127 cases, T221 cases, T325 cases, T422 cases. Results The positive rate of MMP2 in renal pelvic carcinoma was 81.2% (95 cases), the positive rate of MMP9 was 72.6% (85 cases), the positive rate of TIMP1 was 72.6% (85 cases), the positive expression intensity and positive cells were unevenly distributed, The cytoplasm of the cells increased with the tumor grade and staging. The positive expression rates of MMP2 and MMP9 showed an increasing trend, which was correlated with the prognosis (P <0.05). The positive expression rate of TIMP1 decreased gradually with the increase of grading and staging, but there was no significant difference (P> 0.05). There was no significant correlation between the expression of TIMP1 and the survival time of patients. Univariate analysis of variance showed that the ratio of MMP9 / TIMP1 was closely related to the clinicopathological grade and stage of the tumor, and increased with the grade and stage (P <0.05). Conclusion The detection of MMP2 and MMP9 is of great value in the pathological classification and staging of renal pelvis cancer. MMP2, MMP9 and MMP9 / TIMP1 ratio in the prognosis of renal pelvic cancer is important.