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目的探讨微卫星不稳定性(MSI)和基质金属蛋白酶9(MMP-9)在膀胱上皮细胞癌(UCC)中的表达及其与肿瘤临床分期、病理分级、术后复发转移及预后的关系。方法选择4个微卫星位点应用PCR方法检测44例UCC和10例正常膀胱组织的MSI,并采用免疫组化(SP法)检测MMP-9的表达。结果 44例UCC中MSI表达率为77.3%,强阳性表达率为45.5%,MMP9阳性表达率为61.4%,强阳性表达率为38.6%。MSI和MMP9的强阳性表达率随分级分期增高而增高(P<0.05),复发组两者强阳性率高于新发组(P<0.05),UCC中MSI与MMP-9强阳性表达组的术后复发率高于弱阳性表达组(P<0.05),术后生存率低于弱阳性表达组(P<0.05)。两者同时表达强阳性组的术后复发转移率高于单个强阳性表达组(P<0.05),术后生存率低于单个强阳性表达组(P<0.05)。MSI和MMP9在10例正常膀胱组织中均呈阴性表达。结论 MSI及MMP-9的表达与UCC的临床分期、病理分级、复发转移密切相关,在膀胱上皮细胞癌诊断和术后随访中有重要意义。
Objective To investigate the expression of microsatellite instability (MSI) and matrix metalloproteinase 9 (MMP-9) in bladder epithelial cell carcinoma (UCC) and its relationship with tumor clinical stage, pathological grade, recurrence, metastasis and prognosis. Methods Four microsatellite loci were selected for detection of MSI in 44 cases of UCC and 10 cases of normal bladder tissue by PCR. The expression of MMP-9 was detected by immunohistochemistry (SP method). Results The positive rate of MSI in 44 UCC cases was 77.3%, the positive rate was 45.5%, the positive rate of MMP9 was 61.4%, and the strong positive rate was 38.6%. The strong positive rate of MSI and MMP9 increased with the staging (P <0.05), and the positive rate of MSI and MMP9 in recurrence group was higher than that in new onset group (P <0.05). The positive rates of MSI and MMP-9 in UCC The postoperative recurrence rate was higher than that of the weak positive expression group (P <0.05), and the postoperative survival rate was lower than that of the weak positive expression group (P <0.05). The positive rate of recurrence and metastasis in the two groups with strong positive expression was higher than that in the single strongly positive group (P <0.05). The postoperative survival rate was lower than that in the single strongly positive group (P <0.05). MSI and MMP9 were negative in 10 cases of normal bladder tissue. Conclusion The expressions of MSI and MMP-9 are closely related to the clinical stage, pathological grade, recurrence and metastasis of UCC, and are of great significance in the diagnosis and postoperative follow-up of bladder epithelial cell carcinoma.