| Objective Immunohistochemical examination the expression of matrix metalloproteinase- 7(MMP- 7)and matrix metalloproteinase- 9(MMP- 9) in early cervical cancer, to explore the relationship between clinical pathological parameters of cervical cancer and pelvic and para-aortic lymph node metastasis. In order to provides the basis of predicting pelvic and para-aortic lymph node metastasis for early stage cervical cancer.Materials and methods We retrospectively analyzed 137 cases of early cervical cancer with clinical stage Ia1 ~ IIa2(FIGO2009), who were performed pelvic and para-aortic lymph nodes dissection in Liaoning province tumor hospital between December 2008 and May 2014. Clinical pathological character including: age, clinical stage, differentiation, histological type, depth of invasion, vascular tumors bolt, pelvic lymph nodes(iliac, external iliac, obturator), common iliac lymph nodes, Para-lymph node. Check the expression of matrix metalloproteinases- 7(MMP- 7) and matrix metalloproteinases 9(MMP- 9) in early cervical cancer by immunohistochemical, to explore the relationship between clinical pathological parameters and pelvic and para-aortic lymph node metastasis. SPSS16.0 was used for statistical analysis,compared of rate by chi-square test, MMP- 7 and MMP- 9 expressions in pelvic and para-aortic lymph node metastasis by nonparametric test, correlation between MMP-7 and MMP-9 were analyzed by Spearman correlation.Results1.137 patients with early cervical cancer were conducted hysterectomy, pelvic and para-aortic lymph node dissection, a total of 35 cases had pelvic lymph node metastasis, and transfer rate was 25.55%(35/137). Pelvic lymph nodes metastasis were happened in 32 cases(including obturator, iliac internal and external iliac), transfer rate was 23.36%(32/137), common iliac lymph node metastasis were in 8 patients, transfer rate was 5.84%(8/137), para-aortic lymph node metastasis in 5 cases, the rate was 3.65%(5/137). The results showed that the expression of MMP- 9 has no correlation with age, stage, pathological type, differentiation and expression of Ki67. The expression of MMP- 9 were significantly higher in vascular nodule bolt and deep muscularis invasion than without vascular nodule bolt(χ2= 8.629, P =0.003, χ2=10.266, P=0.001). In the lymph node metastasis group, the expression of MMP- 9 was significantly higher than that of group without lymph node metastasis, difference was statistically significant(χ2 = 8.932, P=0.003). And the expression of MMP- 7 had no significant correlation with age, FIGO staging, differentiation, deep muscularis invasion.Expression of MMP- 7 in cervical adenocarcinoma is higher than squamous cell carcinomas,difference was statistically significant(χ2= 6.053, P =0.014).MMP-7 expression was significantly associated with Ki67 expression in cervical tissue(χ2= 38.144, P =0.000). with the higher expression of MMP – 7 in vascular nodule bolt than without vascular nodule bolt of cervical cancer patients(χ2= 4.161, P =0.041).In the cervical lymph node metastasis group,the expression rate of MMP- 7 is higher than without lymph node metastasis group, the difference was statistically significant(χ2= 18.729, P =0.000).2. The relationship between MMP- 7 expression and common iliac and para-aortic lymph node metastasis By further analysis, we found that the strength of MMP- 7 expression Of MMP- 7 in the pelvic and para-aortic iliac lymph nodes metastasis is higher than without lymph node metastasis group(Z = 4.846, P = 0.000), MMP- 7 are positive expression in 8 cases of cervical tissue, whose common iliac lymph node were metastasis, including 1 case of weak positive, 5 cases were positive, 2 cases were strong positive, but found no statistical significant difference in the expression of MMP- 7 associated with common iliac lymph node metastasis(Z=-1.617, P=0.106).we found MMP- 7 expressed in 5 cases with para-aorticlymph node metastasis, of which 3 positive, 2 strong positive, compared with no abdominal aorta by lymph node metastasis group, there was no statistically statistical analysis(Z=-1.931,P=0.053).3. The relationship between MMP- 9 expression and common iliac and para-aortic lymph node metastasis When analyzed the expression of MM-9 in cervical tissue according to the rating classification as negative, weak positive, positive and strong positive, nonparametric analysis found expression of MMP – 9 in lymph node metastasis group is higher than without lymph node metastasis group(Z =-3.183,P=0.001), expression of MMP–9 in common iliac lymph node metastasis group is higher than without lymph node metastasis group(Z =-3.258,P=0.001). MMP- 9 expression in para-aortic lymph node metastasis group is higher than without para-aortic lymph node metastasis group(Z=-2.891, P= 0.004).4. The relationship between MMP- 7 and MMP- 9 expressions in cervical cancer We further analyzed the correlation between MMP- 7 and MMP- 9 expression by Spearman test and found that MMP- 7 and MMP- 9 expression were positively correlated in cervical cancer(r=0.263, P=0.002).5. The value of MMP- 7 and MMP- 9 expression for the forecast of lymph node metastasis in cervical cancer The area under the ROC curve of MMP- 7, MMP- 9 are 0.646 and 0.707 respectively, which indicate MMP- 7 and MMP- 9 can forecast the risk of lymph node metastasis in cervical cancer.Conclusion1. Both MMP- 7 and MMP- 9 have higher positive expression rate in cervical cancer tissues. The expression of MMP- 7 had obvious correlation with lymph node metastasis and pathological types, deep muscularis invaded, vascular nodule bolt and Ki67. MMP- 7expressions had no correlation with patients’ age, FIGO stage, differentiation, deep muscularis invasion. While the expression of MMP- 9 had significant correlation with vascular nodule bolt, lymph node metastasis, deep muscularis invasion but has no obvious correlation with age, stage, pathological type, and differentiation and Ki67 expression.2. MMP- 7 and MMP- 9 expressions were positively correlated in cervical cancer tissues, we can speculate that the two may be play a role in the promotion of invasion, metastasis and lymph node metastasis of cervical cancer promoting together.3. The ROC curve found the expression of MMP- 7 and MMP- 9 was associated with pelvic and para-aortic lymph node metastasis, we can thought that testing MMP- 7 and MMP- 9expression can predicate the risk of cervical lymph node metastasis... |
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