Survivin、MMP-2、TIMP-2在宫颈癌中的表达及其与侵袭、转移的关系

目的　探讨生存素(Survivin)、基质金属蛋白酶2(MMP 2)、基质金属蛋白酶抑制剂2(TIMP 2)蛋白在人宫颈癌中的表达及其与宫颈癌组织侵袭、转移的关系。方法　采用免疫组织化学S P法和图像分析系统检测Survivin、MMP 2及TIMP 2在10例正常宫颈组织、10例宫颈原位癌、40例宫颈鳞癌和11 例宫颈腺癌中的表达,分析表达结果与临床病理特征的关系。结果　从正常宫颈上皮→原位癌→浸润癌,Survivin、MMP 2 阳性表达量显著升高(P<0.05),TIMP 2的表达与病理分级无关。宫颈癌Survivin、MMP 2、TIMP 2表达量与盆腔淋巴结转移、局部侵袭、组织学类型及患者年龄有关(P<0.05),而与FIGO分期、组织学分级无关(P>0.05)。有盆腔淋巴结转移、有脉管或/和间质侵袭、年龄小于35岁者Survivin、MMP 2阳性表达量增多,而TIMP 2阳性表达量减少(P<0.05);腺癌Survivin阳性表达量高于鳞癌,而其MMP 2、TIMP 2的表达则低于鳞癌(P<0.05)。结论　Survivin、MMP 2和TIMP 2蛋白异常表达在宫颈癌恶化、侵袭和转移中起重要作用, 联合检测这些指标可以预测宫颈癌组织的侵袭和转移能力。

Expressions of Survivin, MMP-2 and TIMP-2 in cervical carcinoma and their relationship with the invasion and metastasis of the cancerous tissues

Objective To investigate the expression of survivin, matrix metalloproteinase (MMP-2) and tissue inhibitor 2 of matrix metalloproteinase (TIMP-2) in cervical carcinoma and their relationship with invasion and node metastasis of the cervical cancerous tissues. Methods The expressions of survivin, MMP-2 and TIMP-2 were examined by immunohistochemical S-P method and colour pathological image computer analysis system in 10 cases of normal cervical epithelia, 10 cases of cervical carcinoma in situ, 40 cases of invasive squamous cell cervical carcinoma and 11 cases of invasive cervical adenocarcinoma. The relationship between those indexes and the factors related to clinical pathology of cervical carcinoma were analyzed statistically. Results It was found that the positive level of survivin and MMP-2 expression increased in the order of normal cervical epithelium, cervical carcinoma in situ and invasive carcinoma of cervix (P<0.05), but there was no statistical difference of TIMP-2 level between them. There was significant correlation between the expressions of survivin, MMP-2 and TIMP-2 and pelvic lymphonode metastasis, intravascular involvement, stroma involvement and histopathological types and ages of patients (P<0.05), but there was no correlation between them and FIGO staging and histropathological grading (P>0.05). The positive expressions of survivin and MMP-2 in patients under 35 years old or with pelvic lymph node metastasis, intravascular involvement and stroma involvement were significantly higher than that in the cases without them, while TIMP-2 expression was opposite to that of MMP-2 (P<0.05). Survivin was expressed significantly more in squamous cell carcinoma cases than in andeocarcinoma cases, and MMP-2 and TIMP-2 were expressed more in andeocarcinoma cases. Conclusion The positive expressions of survivin, MMP-2 and TIMP-2 in invasive cervical carcinoma might play an important role in the development, lymph node metastasis, intravascular and stroma involvement of cancer cells. Their level may act as an index to indicate the process of the invasion and node metastasis in cervical carcinoma.