目的检测早期乳腺癌患者血清中基质金属蛋白酶2(MMP-2)及细胞角蛋白19(CK19)的表达水平,探讨二者的相互关系及临床意义。方法应用ELISA法分别检测10例乳腺纤维腺瘤患者及72例乳腺癌患者血清中MMP-2的水平,同时应用实时定量反转录-聚合酶链反应方法检测相应患者外周血CK-19的表达水平,并进行相关性分析。结果MMP-2在乳腺癌患者血清中的表达水平为12.24μg/L,明显高于乳腺纤维腺瘤患者(2.21μg/L),二者差异有统计学意义(P=0.003);在人表皮生长因子受体2(HER-2)阳性的乳腺癌患者中,血清MMP-2水平明显高于HER-2阴性患者(16.77μg/L与10.02μg/L,P=0.022)。CK19在乳腺纤维腺瘤患者外周血中未见表达,在乳腺癌患者外周血中,阳性表达30例(41.7%),在CK19阳性乳腺癌患者血清中,MMP-2水平为(15.48±2.02)μg/L,显著高于CK19阴性患者(7.16±1.55)μg/L(P=0.013)。结论早期乳腺癌患者血清MMP-2水平与外周血微转移密切相关,提示血清MMP-2的高表达可能是导致乳腺癌转移的因素之一。
Objective To explore the serum levels of MMP-2 in early breast cancer and its clinical significance and correlation with the circulating tumor cells in the patients. Methods The serum levels of MMP-2 in breast fibroadenoma ( n = 10 ) and breast cancer ( n = 72 ) were detected by enzyme-linked immunosorbent assay (ELISA). And CK19 mRNA was measured by quantitative reverse transcription- polymerase chain reaction in blood as an index of circulating tumor cells in the patients. Results The serum level of MMP-2 in breast cancer was significantly higher than that in breast fibroadenoma ( 12. 24 vs 2. 21 p~g/L, P = 0. 003 ). Subgroup analysis showed that the serum levels of MMP-2 were higher in HER-2 positive patients than those in HER-2 negative ones ( 16.77 vs 10. 02 Ixg/L, P =0. 022). CK19 mRNA was found in blood samples from 30 cases of breast cancer and the positive rate was 41.7%. However, it was not detected in the patients with breast fibroadenoma. The mean levels of serum MMP-2 were ( 15.48 ± 2. 02) and (7.16 ± 1.55) p,g/L in CK19 positive and negative patients respectively. Significant difference existed between two groups ( P = 0.013). Conclusion The serum level of MMP-2 in early breast cancer is closely correlated with blood micrometastasis. And its high level may be an important contributing factor for the metastasis of breast cancer .