结肠癌中晚期存活30年【MMP-2、MMP-9及VEGF在结肠癌中的表达及其与肿瘤转移的相关性】

　　[摘要] 目的 探讨基质金属蛋白酶-2（MMP-2）、基质金属蛋白酶-9（MMP-9）及血管内皮生长因子（VEGF）在结肠癌中的表达，并分析其与肿瘤转移的相关性。 方法 86例经病理证实的结肠癌患者，采用免疫组化SP法检测MMP-2、MMP-9及VEGF在结肠癌组织及正常结肠组织中的表达，分析三者间的相关性及其与肿瘤转移的相关性。 结果 结肠癌组织中MMP-2、MMP-9及VEGF表达水平及阳性率均显著高于正常结肠组织（P ＜ 0.05、0.01），其中有淋巴结转移的结肠癌组织中MMP-2、MMP-9及VEGF阳性表达率高于无淋巴结转移者（P ＜ 0.05）；MMP-2、MMP-9与VEGF表达之间呈显著正相关（r = 0.72，P ＜ 0.05）。 结论 结肠癌组织中MMP-2、MMP-9及VEGF高表达与肿瘤转移密切相关，三者可作为反映结肠癌进展的重要指标，为判断患者的预后提供依据。
　　[关键词] 结肠癌；基质金属蛋白酶；血管内皮生长因子；肿瘤转移
　　[中图分类号] R735.3+5 [文献标识码] A [文章编号] 1673-7210（2012）07（c）-0044-03
　　Expression of MMP-2, MMP-9 and VEGF in colon carcinoma and their correlations with metastasis
　　DUAN Chuanyou
　　Department of the Second Surgery, the People′s Hospital of Liuhe District, Jiangsu Province, Nanjing 211500, China
　　[Abstract] Objective To explore the expressions of MMP-2, MMP-9 and VEGF in colon carcinoma, and analyze their correlations with tumor metastasis. Methods 86 patients with colon carcinoma confirmed by pathology were enrolled in our study, and the expressions of MMP-2, MMP-9 and VEGF in colon carcinoma and normal colon tissues were determined by using immunohistochemistry SP assay, the correlations among the three indexes and relationships with tumor metastasis were also investigated. Results In colon carcinoma tissues, the expression levels and positive rates of MMP-2, MMP-9 and VEGF were statistically higher than those of normal colon tissues (P ＜ 0.05, 0.01), patients with lymph node metastasis showed significantly higher positive rates of MMP-2, MMP-9 and VEGF than those of patients without lymph node metastasis (P ＜ 0.05). It showed obvious positive correlation among MMP-2, MMP-9 and VEGF (r = 0.72, P ＜ 0.05). Conclusion The high expressions of MMP-2, MMP-9 and VEGF in colon carcinoma are closely related to tumor metastasis, these three indexes can reflect the progress of colon carcinoma and provide basis for judging the prognosis of patients with colon carcinoma.
　　[Key words] Colon carcinoma; Matrix metalloproteinases; Vascular endothelial growth factor; Tumor metastasis
　　结肠癌（colon cancer）是胃肠道最常见的恶性肿瘤，发病高峰年龄为41～51岁，5%的患者30岁以下发病。近年来，结肠癌发病率有逐渐上升趋势，以大城市发病率增高为主，在北京、上海等大城市中，结肠癌发病率已上升到恶性肿瘤的前3位，其死亡率也逐渐升高，成为一个重大社会问题[1]。目前手术治疗是结肠癌的有效治疗方法，但术后结肠癌侵袭转移可导致术后复发甚至死亡。研究表明，细胞外基质（extracellular matrix，ECM）降解和新生血管形成是肿瘤生长、浸润和转移的基础[2-3]。基质金属蛋白酶（matrix metalloproteinases，MMPs）能够通过降解细胞外基质和血管基底膜促进肿瘤细胞浸润和血管形成[4]，而血管内皮生长（vascular endothelial growth factor，VEGF）则通过与VEGF受体结合促进新生血管形成，参与肿瘤的发生及发展[5]。本研究旨在通过检测MMP-2、MMP-9及VEGF在结肠癌组织中的表达，并分析其与肿瘤转移的相关性，评价三者在结肠癌进展中的作用。