HE4、NF-κBp65和MMP-9在卵巢上皮性肿瘤中的表达及其临床意义

目的探讨HE4、NF-κBp65以及MMP-9的表达与上皮性卵巢肿瘤临床病理生物学行为的关系以及对患者预后的影响。方法应用免疫组化对80例卵巢上皮性癌、10例交界性上皮性肿瘤及10例良性上皮性肿瘤组织进行HE4、NF-κB p65及MMP-9蛋白的检测。结果 HE4、NF-κBp65及MMP-9蛋白的阳性表达率在卵巢癌组均高于交界性及良性肿瘤组（P〈0.05）。三个指标的表达与EOC的组织学分级、腹腔脏器及淋巴结转移以及PTNM临床分期有关（P〈0.05）;在EOC中,NF-κBp65分别与HE4、MMP-9的表达呈正相关（r1=0.673,P〈0.05;r2=0.775,P〈0.05）。多因素分析,PTNM分期、MMP-9的表达是影响卵巢癌术后患者预后的独立因素（P〈0.05）;HE4阳性组与阴性组5年生存率分别为12.7%和84.0%,MMP-9阳性组与阴性组5年生存率分别为8.7%和70.6%,差异均有统计学意义（P〈0.05）。结论 NF-κBp65可能通过上调HE4、MMP-9的表达促进EOC的浸润和转移,联合检测HE4、NF-κBp65以及MMP-9的表达可能作为预测和评价患者预后的生物学指标。

Expression of HE4,NF-κB p65,MMP-9 and Their Clinical Significance in Epithelial Ovarian Noeplasm

Objective To study the association of the expression of HE4,NF-κBp65 and MMP-9 with the clinicobiologic behavior and prognosis of epithelial ovarian neoplasm.Methods Immunohistochemical staining was used to detect the expression of HE4,NF-κBp65 and MMP-9 proteins in 80 cases of EOC,10 cases of borderline epithelial tumors and 10 cases of benign epithelial tumors.Results The positive expression of HE4,NF-κBp65 and MMP-9 proteins in EOC were higher than those in borderline and benign tumors of the ovary,and there were significant differences among the three（P0.05）.The 3 indexes in EOC were significantly related to differentiation,abdominal organ and lymph node metastasis,and PTNM stage,respectively（P0.05）.There was a positive correlation between the expression of NF-κBp65 and HE4（r1=-0.673,P0.05）,MMP-9（r2=-0.775,P0.05）.PTNM stage and MMP-9 expression were independent prognosis factors of EOC（P0.05）.The 5-year survival rate was significantly different between the HE4-positive and HE4-negative groups（12.7% vs 84.0%,P0.05）,and between the MMP-9-positive group and the MMP-9-negative group（8.7% vs 70.6%,P0.05）.Conclusion Through up-regulationing the expression of HE4 and MMP-9,NF-κBp65 may promote invasion and metastasis of EOC.Thus detecting HE4,NF-κBp65 and MMP-9 can be used as markers to predict the prognosis of EOC patients.