Expressions Of TFPI-2and MMP-9in Esophageal Squamous Cell Carcinoma Tissue And Relationship With Vasculogenic Mimicry

BackgroudEsophageal cancer is the most common malignancy which incidence is fouth inchina.China is one of the countries with the highest incidence of esophageal cancerand mortality.Most patiences has been clinically diagnosed with advanced stagebecause of the occult of the symptom,and the tumor is easy to invasion andmetastasis.New research shows that: vasculogenic mimicry(VM) is associated withtumor invasion and metastasis.Therefore,it is very hot in esophageal cancer researchto find the target which is important in the formation of VM。VM is a newconcept,which is different with conventional Angiogenesis. Highly malignant tumorcells transformed and constructed tracts which can contact with conventional artery.This tract can help tumor cell invasion and metastasis.VM has great significance intumor biology,treatment can have a better effect if therapy aimed both at the tumormicrocirculation and angiogenesis.ObjectiveTo investigate the expressions of tissue factor pathway inhibitor-2(TFPI-2) andmatrix metalloproteinase9(MMP-9) in esophageal squamous cell carcinoma（ESCC）tissue and relationship with vasculogenic mimicry (VM).Methods:162cases of esophageal squamous cell carcinoma tissues with detailed follow-updata were collected in surgery from september2003to december2008.CD34/periodic acid-schiff double stain was performed to observe the distribution ofVM in ESCC, immunohistochemical staining was performed to validate TFPI-2andMMP-9. Analyzing relationship between VM expression and clinicopathologicparameters of esophageal squamous cell carcinoma,VM expression and expressions ofTFPI-2and MMP-9. Results:The positive rate of VM in esophageal squamous cell carcinoma tissue was20.37%.The positive rate of VM in poorly differentiated group(40.38%) was significantlyhigher than those in moderately differentiated group(11.76%) and well differentiatedgroup(7.14%)（X2=20.915，P＜0.01）. The positive rate of VM in TNM I-II (11.59%)was significantly higher than that in TNM III group(26.88%)（X2=5.707，P=0.017）.The positive rate of TFPI-2in VM(+) group(33.34%) was significantly higher thanthose in VM(-) group(6.45%)（x2=4.582，P=0.032） in poorly differentiated ESCC.The positive rate of MMP-9in VM(+) group(78.79%) was significantly higher thanthose in VM(-) group(44.96%)（x2=12.05，P=0.001）. The five-year survival rate inVM-negative group was significant higher than that in VM-positive group(X2=22.84，P＜0.001)．Conclusion:VM exists in ESCC, especially in poorly differentiated and advanced esophagealsquamous cell carcinoma tissue. VM is an unfavorable prognostic indicator for ESCC.TFPI-2and MMP-9might involve in the formation of VM in ESCC.