TFPI-2和MMP-9在食管鳞状细胞癌组织中的表达及其与血管生成拟态的关系

摘要

目的：探讨组织因子途径抑制剂2（TFPI-2）和基质金属蛋白酶9（MMP-9）在食管鳞状细胞癌中的表达及其与血管生成拟态（VM）的关系。方法：收集手术切除的162例食管鳞状细胞癌标本，采用过碘雪夫酸（PAS）和CD34双重染色法观察 VM在食管鳞状细胞癌组织中的分布特征。采用免疫组织化学 SP 法检测 TFPI-2和MMP-9在食管鳞状细胞癌组织中的表达情况。分析 VM与食管鳞状细胞癌临床病理参数以及 TFPI-2和 MMP-9表达的关系。结果：食管鳞状细胞癌组织中 VM阳性率为20.37％。低分化组 VM阳性率（40.38％）高于中分化组（11.76％）和高分化组（7.14％），3组间比较差异有统计学意义（χ2＝20.915，P＜0.01）。TNM Ⅰ-Ⅱ期组 VM阳性率（11.59％）低于Ⅲ期组（26.88％）（χ2＝5.707，P＝0.017）。在低分化组中，TFPI-2在 VM（＋）组的表达率[33.34％（7／21）]高于 VM（-）组[6.45％（2／31）]（χ2＝4.582，P＝0.032）；MMP-9在 VM（＋）组的表达率[78.79％（26／33）]高于 VM（-）组[44.96％（58／129）]（χ2＝12.05，P＝0.001）；低分化组 TFPI-2的表达水平与VM呈正相关关系（r＝0.166，P＝0.032），MMP-9的表达水平与 VM呈正相关关系（r＝0.183，P＝0.018）， VM（-）组5年生存率高于 VM（＋）组（χ2＝22.84，P＜0.001）。结论：低分化及晚期食管鳞状细胞癌易形成VM， VM与食管鳞状细胞癌的不良预后有关，且TFPI-2和 MMP-9对 VM的形成有促进作用。%Objective To investigate the expressions of tissue factor pathway inhibitor-2 (TFPI-2 ) and matrix metalloproteinase-9 (MMP-9)in esophageal squamous cell carcinoma(ESCC)tissue and their relationship with vasculogenic mimicry (VM).Methods 162 cases of esophageal squamous cell carcinoma tissues were collected. CD34/periodic acid-schiff double staining was performed to observe the distribution of VM in ESCC tissue,and immunohistochemical staining was used to detect the expressions of TFPI-2 and MMP-9 in ESCC tissue. The relationship between VM and the clinicopathologic parameters of ESCC, the expressions of TFPI-2 and MMP-9 were analyzed.Results The positive rate of VM in ESCC tissue was 20.37%.The positive rate of VM in poorly differentiated group(40.38%)was significantly higher than those in moderately differentiated group(11.76%)and well differentiated group (7.14%)(χ2 = 20.915, P < 0.01 ). The positive rate of VM in TNM Ⅰ-Ⅱ(11.59%)group was significantly lower than that in TNM Ⅲ group(26.88%)(χ2=5.707,P=0.017).The positive rate of TFPI-2 in VM(+)group(33.34%)was significantly higher than that in VM(-)group(6.45%) (χ2=4.582,P=0.032)in poorly differentiated ESCC.The positive rate of MMP-9 in VM(+)group(78.79%) was significantly higher than that in VM(-)group(44.96%)(χ2=12.05,P=0.001).The expression level of TFPI-2 in poorly differentiated group was positively correlated with VM (r= 0.166,P= 0.032 ), and the expression level of MMP-9 was positively correlated with the VM(r=0.183,P=0.018).The five-year survival rate in VM (-) group was significant higher than that in VM (+) group (χ2 = 22.84, P < 0.001 ). Conclusion VM exists in ESCC tissue,especially in poorly differentiated and advanced ESCC tissue.VM is related to poor prognostis of ESCC.TFPI-2 and MMP-9 might involve in the formation of VM in ESCC.