The value of combined detection with MMP-9 and uPA in prognosis of pancreatic carcinoma

Abstract

Objective To explore the value of combined detection with MMP-9 and uPA in the prognosis of pancreatic carcinoma. Methods By immunohistochemistry PV methods, the expression of MMP-9 and uPA was respectively studied in 63 surgical specimens of primary pancreatic carcinoma and the survival time of patients with pancreatic carcinoma was analysed. Results The expressions of MMP-9 and uPA were positively related (r=0.573, P=0.000). The expression of MMP-9 and uPA significantly correlated with differentiation(r=-0.271, P=0.032; r=-0.333, P=0.008), TNM stages(r=-0.449, P=0.000; r=-0.430, P=0.000)and lymph node metastasis(r=0.329, P=0.009; r=0.400, P=0.001), separately. The expression of MMP-9 had also a significant correlation with tumer size(r=-0.297, P=0.018)and distant metastasis(r=0.320, P=0.011). Univariate analysis identified that tumor size(χ2=8.766, P=0.012), differentiation(χ2=29.050, P=0.000), clinical stage(χ2=24.940, P=0.000), distant metastasis(χ2=12.846, P=0.000), lymph node metastasis(χ2=15.457, P=0.000), MMP-9(χ2=32.700, P=0.000)and uPA(χ2=41.495, P=0.000)were significantly associated with prognosis. Kaplan-Meier survival analysis showed that 1-year survival rate of patients with MMP-9 (-), uPA (-)were significantly longer than that of the patients with MMP-9 (+ ), uPA (+ ), respectively(χ2=32.700, P=0.000; χ2=41.495, P=0.000); 1-year survival rate of patients with MMP-9 (-)/uPA(-)was significantly longer than the others(Log-rank test, χ2= 54.892, P=0.000). COX regression revealed that differentiation (RR=2.315, P=0.004), clinical stage(RR=1.694, P=0.002), MMP-9(RR=0.165, P=0.000) and uPA(RR=0.244, P=0.007)was independent prognostic factors in pancreatic carcinoma. Conclusion They may have a synergistic function in the the process of growth and invasion in pancreatic cancer between MMP-9 and uPA, and the posssible mechanism is that uPA activate degradation of MMP-9, which is not favorable to prognosis.Combined analysis of MMP-9 and uPA may lead to a more reliable prognostic estimation, as the beneficial supplement of the differentiation, and clinical stage to judge the prognosis of pancreatic cancer. Key words: Pancreatic neoplasms; Prognosis; Matrix metalloproteinase 9; Urinary plasminogen actirator