摘要
背景与目的:细胞外基质金属蛋白酶诱导因子(extracellular matrix metalloproteinase inducer,EMMPRIN,CD147)属于免疫球蛋白家族,在肿瘤细胞中表达增高。EMMPRIN表达增加与肿瘤浸润、转移、耐药以及某些肿瘤细胞的生存相关,但与宫颈癌的关系尚未阐明。本研究旨在确定EMMPRIN是否与宫颈癌发生、发展有关。方法:采用免疫组化法检测21例慢性宫颈炎、22例宫颈上皮内瘤变3级(cervical intraepithelial neoplasia,CIN3)、82例宫颈浸润癌原发灶和22例转移淋巴结中EMMPRIN的表达,并比较EMMPRIN在宫颈病变不同阶段的表达。结果:随着宫颈病变的发展,EMMPRIN过表达阳性率明显升高:宫颈浸润癌中过表达阳性率(52.4%)>CIN3(21.3%)>慢性宫颈炎(0%)(P=0.000)。宫颈原发灶EMMPRIN的过表达与盆腔淋巴结转移呈正相关,有转移组原发灶EMMPRIN过表达为72.7%,无转移组为45.0%,两组间差异有显著性(P=0.026)。在有淋巴结转移的患者中,原发灶和转移灶中EMMPRIN的过表达差异无显著性(72.7%vs54.5%,P=0.210)。EMMPRIN过表达与其他临床病理因素如临床分期、病理类型、组织学分级、脉管浸润、肿瘤大小、浸润深度等无明显相关性。采用Kaplan-Meier方法和Log-Rank检验,单因素分析生存率,宫颈癌EMMPRIN的过表达无任何预后价值,淋巴结转移、深肌层浸润和脉管侵犯提示生存预后差。所有上述因素进入COX比例风险模型多因素分析,采用BackwardLR方法,显示淋巴结转移与患者生存相关(P=0.006;HR=0.380;95%可信区间:0.190～0.763)。结论:EMMPRIN与宫颈癌侵袭转移相关,在宫颈癌的发生、发展中起着重要作用。
Background and purpose： Overexpression of extracellular matrix metalloproteinase inducer （EMMPRIN）, a member of the immunoglobulin family and a glycoprotein enriched on the surface of tumor cells, is linked to invasion, metastasis, growth and survival of some malignant cells. But the association has not been demonstrated in patients with cervical cancer. The purpose of this study was to determine whether EMMPRIN is associated with the development and progression of cervical cancer. Methods： Expression of EMMPRIN was examined by immunostaining in 21 chronic cervicitis, 22 cervical intraepithelial neoplasia（CIN3）, 82 invasive cervical cancer and 22 corresponding metastatic pelvic lymph nodes. Results： Overexpression of EMMPRIN correlated significantly with disease progression, invasive cancer （52.4%） 〉 CIN3 （21.3%） 〉chronic cervicitis （0%）, （P=0.000）. The positive rates of EPMMPRIN overexpression in metastatic lymph nodes was 54.5% （12/22）, no difference was found from corresponding primary tumor（72.7%,P=0.210）. But EMMPRIN overexpression in primary tumor was related to lymph node metastasis （P=0.026）, no relationship was found between EMMPRIN expression and other clinical-pathological parameters. Univariate analyses revealed that EMMPRIN expression did not correlate to tumor-specific survival. In contrast, lymph vascular space invasion, deep stromal invasion and lymph node metastasis were significantly associated with poor prognosis. In multivariate analysis, lymph-node metastasis was the independent prognostic factor for tumor-specific survival （P=0.006;HR=0.038; 95% confidence interval, 0.019- 0.763）. Conclusion： EMMPRIN overexpression may play an important role in progression of human cervical cancer, and in the development of cervical cancer from CIN.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2009年第2期91-96,共6页
China Oncology
基金
国家自然科学基金(No:30672417)
