【作者】 柳海；

【导师】 吴强； 胡向阳；

【作者基本信息】 安徽医科大学 ， 病理学与病理生理学， 2003， 硕士

【摘要】 目的：研究基质金属蛋白酶-9(matrix metalloproteinase-9,MMP9)、E-钙粘蛋白(E-cadherin,E-cad)、及CD44拼接变异体6(CD44 splice variant 6，CD44v6)在口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)中的表达及其与临床病理特征的关系，探讨它们与OSCC发生，发展的关系以及OSCC侵袭和转移的机制。 方法：应用免疫组织化学链霉素抗生物素-过氧化物酶法(S-P法)检测82例口腔鳞状细胞癌，40例口腔粘膜鳞状上皮非典型增生和30例正常口腔粘膜中MMP9、E-cad和CD44v6的表达。 结果： (1) MMP9在OSCC组中的阳性率为84.1％，显著高于非典型增生组的17.5％和正常口腔粘膜组的6.6％(均P＜0.05)。MMP9的高表达率与肿瘤大小，临床分期，淋巴结转移呈正相关，与肿瘤分化程度呈负相关。 (2) E-cad在正常口腔粘膜组中均为阳性，在OSCC中的阳性率为76.9％，二者有显著性差异(P＜0.05)。E-cad在OSCC中的高表达率与肿瘤分化程度呈正相关，与肿瘤大小、肿瘤淋巴结转移呈负相关，但与临床分期无关。 (3) CD44v6在OSCC组中的阳性率为78.4％，显著高于非典型增生组的30.0％和正常口腔粘膜13.3％(均P＜0.05)。CD44v6的高表达率与淋巴结转移呈正相关，与肿瘤分化程度呈负相关，与肿瘤大小、临床分期无关(P＞0.05)。 (4) OSCC中MMP9的表达与E-cad表达呈负相关，与CD44v6表达呈正相关；E-cad表达与CD44v6表达无关。安徽医科大学硕十学位论文 (5)高表达MMPg的OscC中，E一cad表达降低或CD44v6高表达时，其淋巴结转移率明显增高(分别为70.4%和71.0%)。高表达E一cad的OSCC中，CD44v6低表达时，淋巴结转移率极低(仅4.3%)。 结论:E一cad、MMPg和CD44v6的表达改变在OSCC发生、发展过程中发挥作用。MMPg、CD44v6的高表达和E一cad低表达均有利于OSCC的淋巴结转移，它们通过不同途径，独立或相互作用，影响OSCC的侵袭和转移，E一cad、MMPg和CD44v6可作为OSCC浸润和转移进展中的重要生物学标志，对它们的联合检测有利于判断OSCC的侵袭和转移能力。更多还原

【Abstract】 Objective: To study the expression of Matrix metalloprateinase-9 (MMP9), E-cadherin (E-cad) and CD44 splice variant 6 (CD44v6) in oral squamous cell carcinoma (OSCC) and their relationships with clinical pathological characteristics and to investigate their roles in carcinogenesis, development, invasion and metastasis of OSCC.Methods: The expression of MMP9, E-cad and CD44v6 was examined by immunohistochermistry S-P method in 30 cases of normal oral mucosa, 40 cases of atypical hyperplasia of oral epithelia and 82 cases of OSCC.Results:(1) The positive rate of MMP9 was 84.1% in OSCC, which was significantly higher than that in atypical hyperplasia (17.5%) and that in oral mucosa (6.6%). Significant correlations were found between MMP9 expression in OSCC and tumor size, differentiation, clinical stage and lymph-node metastasis.(2) All 30 cases of normal mucosa expressed E-cad. The positive rate of E-cad was 76.9% in OSCC, which was significantly lower than that in normal mucosa. The strong positive staining for E-cad in OSCC was closely related with tumor size, its differentiation and lymph-node metastasis, but it had no relation with the clinical stage.(3) The positive rate of CD44v6 was 78.4% in OSCC, which was significantly higher than that in atypical hyperplasia (30.0%) and in oral mucosa (13.3%). The expression of CD44v6 in OSCC was closely related with the turner differentiation andlymph-node metastasis, but had no relation with tumor size and clinical stage.(4) In OSCC, MMP9 expression was negatively related to that of E-cad, while positively to CD44v6, no relation of E-cad to CD44v6 was evident.(5)In OSCC with high expression of MMP9, there were high rates of lymph-node metastasis (70.4% and 71%,respectively) in case of the lower expression of E-cad and high expression of CD44v6. While in OSCC with high expression of E-cad, the rate of lymph-node metastasis was very low, which was only 4.3%, in case of the low expression of CD44v6.Conclusion: The altered expression of MMP9, E-cad and CD44v6 may take important roles in the carcinogenesis and development of OSCC. Low expression of E-cad, high expression of MMP9 and CD44v6 might have advantages for the metastasis of OSCC. They take roles independently or by cooperation in tumor invasion and metastasis through different pathways. The expression of MMP9, E-cad and CD44v6 may be important markers reflecting the biological behaviors of invasion and metastasis in OSCC. The combined of the three markers is helpful for judging the potential of invasion and metastasis of OSCC.更多还原