Cutaneous Squamous Cell Carcinoma. Reck And Mmp-2 Expression And Clinical Significance

Objective:To study the expression of RECK and MMP-2 (matrix metalloproteinase-2) protein in Cutaneous Squamous Cell Carcinoma (CSCC), Bowen's disease and atypical hyperplasia, and perform an analysis of their correlation with the occurrence, development, invasion and metastasis of cancer.Methods:PV6000 immuno-histochemistry method was used to detect the expression of RECK and MMP-2 in 55 cases of patients with CSCC(with 10 cases of lymph node metastasis),13 cases of patients with Bowen's disease (BD),24 cases of atypical hyperplasia (AH) and 20 cases of normal cutaneous epithelium (CE). SPSS13.0 was used to analyze the variability and correlations.Results:1. The positive expression of RECK protein was mainly found in the cytoplasm of normal epithelial cells and some in CSCC cells, shown as pale yellow or buffy in color. The positive expression of MMP-2 is mainly detected in cytoplasm and appeared to be buffy or brown in color.2. The expression rate of RECK protein decreased gradually in CE(85.0%), AH(54.2%), BD(46.2%) and SCC(43.6%) respectively and there were significant differences amoung four groups (P<0.05).3. The expression rate of MMP-2 protein increased gradually in CE, AH, BD and SCC (25.0%,50.0%,53.8%,63.6% respectively), which revealed statistic significance (p<0.05).4. The expression rates of RECK and MMP-2 were both correlated with histological grading of CSCC cells. The expression rate of RECK protein increased when CSCC is well differentiated, but decreased in MMP-2 in cells of good differentiation. The difference was significant (P<0.05).5. The expression rate showed significant change when lymph node metastasis happened. RECK had a higher expression rate in groups without lymph node metastasis(P<0.01), and MMP-2 had a higher expression rate in groups with lymph node metastasis(P<0.01). However, there is no significant difference in groups with distant metastasis(P>0.05).6. The expression of RECK and MMP-2 had no correlation with the patients' age and sex (P>0.05).7. A negative correlation was revealed between the expression of RECK and MMP-2. (r=-0.402, P<0.01).Conclusion:1. It is well documented in our study that the expression rates of RECK and MMP-2 were both correlated with the histopathological grading of epithelial cells. The expression rate of RECK protein increased when CSCC was well differentiated, but in contrast, increased in MMP-2 when the epithelial cells were poorly differentiated. This result indicates that both RECK and MMP-2 may play important roles in tumor genesis and development, which clinically could be used as markers.2. Along with the decrease of histopathological differ en tiaton, RECK protein showed a decrease in expression rate while MMP-2 protein showed an increase in expression rate in the same situation. This might indicate that RECK plays a certain role in surpressing of CSCC through inducing cell differentiation. On the other hand, the increase of expression rate of MMP-2 could be a surpressing factor that inhibits cell differentiation and causes the spreading of malignancy.3. Our research showed that the change of the expression rate of RECK and MMP-2 protein is correlated with CSCC lymph node metastasis. The decrease in expression rate of RECK and increase in MMP-2 expression rate indicate that the tumor might be more invasive which has a higher rate of lymph node metastasis.4. The decrease of RECK expression rate in CSCC cells has correlation with the increase of MMP-2 protein, which suggests that the absence of RECK expression could be the reason or at least one of the influence factors that decrease the inhibition effect to MMP-2, possibly enhance the invasion and metastasis of tumor cell.