MMP-2及CK19在早期宫颈癌淋巴结微转移中的表达及其意义

摘要

目的:检测MMP-2和CK19在早期宫颈癌盆腔淋巴结中的表达,探讨淋巴结微转移的表达及意义.方法:采用免疫组化法对64例早期宫颈癌患者常规病理光镜检查证实无转移淋巴结902枚进行MMP-2及CK19的检测.结果:1)复发组477枚淋巴结中11枚CK19阳性(2.3%),来自32例患者中的8例(25.0%);8枚MMP-2阳性(1.7%),来自32例患者中的6例(18.8%),两种检测指标的结果有较好的一致性.未复发组425枚淋巴结中均无CK19及MMP-2阳性表达(0/425),该组32例患者中CK19及MMP-2的阳性表达率均为0.二者之间比较差异有统计学意义.2)CK19及MMP-2表达与病理类型及组织的分化程度均有相关性(P＜0.05).3)复发组32例患者中带瘤生存25例,死亡7例,且均死于癌症,其中6例患者盆腔淋巴结中的CK-19及MMP-2检测均表达阳性,微转移与术后复发转移有相关性(P＜0.05).结论:采用免疫组化技术检测淋巴结中CK19及MMP-2表达可检测出早期宫颈癌淋巴结中的微转移,显著提高微转移的检出率.通过本研究证实MMP-2及CK19的高表达与宫颈癌的侵袭转移有关,可作为检测早期宫颈癌淋巴转移的生物学指标之一,指导临床治疗.%Objective: To evaluate the significance of the matrix metalloproteinase-2 ( MMP-2 ) and cytokeratin 19 ( CK19 ) expressions in the pelvic lymph nodes of patients with early stage cervical cancer.Methods: Immunohistochemical staining and light microscopy were used to detect the expression of MMP-2 and CK19 in 902 lymph nodes from 64 patients.A routine pathological examination was performed to confirm lymph node metastasis.Results: In the relapse group, 11 of 477 patients had CK19-positive lymph nodes ( 2.3％ ); from 8 of 32 patients ( 25％ ), 8 were MMP-2 positive ( 1.7％ ) from 32 patients in 6 ( 18.8％ ), the results of the two test targets are in good agreement.In the group without recurrence, the 425 lymph nodes from 32 patients showed negative CK19 and MMP-2 expression ( 0/425 ).The difference between the two protein expressions was statistically significant.CK19 and MMP-2 expression, pathological type, and tissue differentiation were all correlated ( P ＜ 0.05 ).Of the 32 patients in the relapse group, 25 survived while 7 died from cancer.A total of 6 cases exhibited positive CK-19 and MMP-2 expression in the pelvic lymph nodes, indicating that micrometastases, postoperative recurrence, and metastasis were correlated ( P ＜ 0.05 ).Conclusion: Compared to traditional histopathological staining, immunohistochemical staining can improve the detection rate for micrometastases.The high MMP-2 expression, CK19 invasion, cervical cancer metastasis, and early cervical cancer detection can be used as biological indicators of lymph node metastasis.