中文摘要：

目的：研究大肠腺瘤-腺癌序列过程中中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和基质金属蛋白酶9（MMP-9）表达的变化及相互关系,以阐明其在大肠癌发生发展中的作用.方法：采用组织芯片与免疫组织化学SP法检测94例瘤旁/癌旁组织、92例腺瘤（其中管状腺瘤36例,管状绒毛状腺瘤47例,绒毛状腺瘤9例）、54例腺瘤伴不典型增生或癌变及60例腺癌中NGAL和MMP-9蛋白的表达情况.结果：在大肠腺癌、腺瘤伴不典型增生或癌变、腺瘤、瘤旁/癌旁组织中,NGAL蛋白表达的阳性率分别为55%（33/60）、37%（20/54）、23%（21/92）和2%（2/94）,MMP-9蛋白表达的阳性率分别为74%（44/60）、44%（24/54）、25%（23/92）、6%（6/94）,NGAL和MMP-9蛋白的表达在腺瘤、腺瘤伴不典型增生或癌变肠腺癌组织中显著高于瘤旁/癌旁组织,差异具有统计学意义（P〈0.01）,并且在正常肠黏膜→腺瘤→腺瘤伴不典型增生或癌变→腺癌这一过程中两者的表达逐渐增高,差异具有统计学意义（P〈0.01）,然而二者在腺瘤组中管状腺瘤、管状绒毛状腺瘤、绒毛状腺瘤三者之间的表达差异无统计学意义（P〉0.05）.NGAL与MMP-9蛋白的表达在整个序列过程中（正常肠黏膜组、腺瘤组、腺瘤伴不典型增生或癌变组、腺癌组）呈显著正相关（rs=0.622,P〈0.01）.结论：NGAL蛋白和MMP-9蛋白表达的上调可能在大肠腺瘤-腺癌序列的发展过程中发挥一定作用,二者的异常表达可能参与大肠腺癌的发生.

英文摘要：

Objective： To investigate the expression and relationship of neutrophilic granulocyte gelatinase-associated-lipocalin （ NGAL ） and matrix metalloproteinase-9 （ MMP-9 ） in the colorectal adenoma-carcinoma sequence, and to evaluate their role in the inci- dence of colorectal carcinoma. Methods： The expression of NGAL and MMP-9 proteins were detected using tissue microarray and S-P immunohistochemical methods in 94 cases with formalin-fixed, paraffin-embedded normal paraneoplastic mucosa which were near ade- noma or carcinoma, 92 cases with adenoma （including 36 with tubular adenoma, 47 with tubulovillous adenoma, and 9 with villous adenoma ）, 54 cases with adenoma of atypical hyperplasia, and 60 cases with colorectal adenocarcinoma. Results： The positive expression rates of NGAL protein were 55 % （ 33/60 ）, 37 % （ 20/54 ）, 23 % （ 21/92 ） and 2 % （ 2/94 ） in colorectal adenocarcinoma, adenoma of atypical hyperplasia, adenoma, and normal tissue adjacent to the adenoma or carcinoma, respectively. The positive expression rates of MMP-9 protein were 74 % （ 44/60 ）, 44 % （ 24/54 ）, 25 % （ 23/92 ）, and 6 % （ 6/94 ） in the aforementioned tissues, respectively. The expression of NGAL and MMP-9 proteins was significantly higher in the adenocarcinoma, adenoma of atypical hyperplasia, and adenoma than in the normal paraneoplastic tissue. There were statistical differences among these groups （ P 〈 0.01 ）. The expression of NGAL and MMP-9 proteins increased gradually during the procession from normal mucosa, adenoma and adenoma of atypical hyperplasia to colorectal adenocarcinoma. There were statistically significant differences among the groups （ P 〈 0.01 ）, while there were no statistical differences among tubular adenoma, tubulovillous adenoma and villous adenoma （ P 〉 0.05 ）. There was a significant positive correlation between the expression of NGAL and MMP-9 proteins during the adenoma-carcinoma sequence （ including normal mucosa of the large bowel, aden