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[目的]探讨食管鳞癌患者外周血中基质金属蛋白酶-9(MMP-9)基因的表达及其与临床病理资料、生存情况的关系。[方法]应用实时定量PCR技术定量检测食管癌外周血标本中MMP-9 mRNA的表达,分析MMP-9基因表达情况与患者临床病理参数及预后之间的关系。[结果]在169例食管鳞癌患者外周血标本中,有106例(62.7%)存在外周血MMP-9基因的阳性表达,与食管癌的淋巴结转移(P=0.039)、远处转移(P=0.019)和TNM分期(P=0.014)显著相关。单因素生存分析显示N分期(P=0.000)、M分期(P=0.002)、TNM分期(P=0.003)、MMP-9表达(P=0.042)对患者生存的影响有统计学意义。MMP-9基因阳性表达的食管癌患者远期生存明显低于阴性表达者。多因素分析显示N分期是食管鳞癌患者预后的独立影响因子(RR=1.671,95%CI:1.212～2.306)。[结论]食管鳞癌患者外周血中MMP-9基因的高表达与食管癌转移存在关联,并可提示食管癌患者的不良预后。
[Objective] To investigate the expression of matrix metalloproteinase-9 (MMP-9) in peripheral blood of patients with esophageal squamous cell carcinoma and its relationship with clinicopathological data and survival. [Method] Quantitative detection of MMP-9 mRNA expression in esophageal cancer peripheral blood by real-time quantitative PCR was used to analyze the relationship between MMP-9 gene expression and clinicopathological parameters and prognosis. [Results] The positive expression of MMP-9 in peripheral blood was detected in 106 cases (62.7%) of 169 cases of esophageal squamous cell carcinoma, which was associated with lymph node metastasis (P = 0.039), distant metastasis = 0.019) and TNM staging (P = 0.014). Univariate survival analysis showed that there was statistical significance in the survival of patients with N stage (P = 0.000), M stage (P = 0.002), TNM stage (P = 0.003) and MMP-9 expression (P = 0.042) The long-term survival of esophageal cancer patients with positive MMP-9 gene expression was significantly lower than those with negative expression. Multivariate analysis showed that stage N was an independent prognostic factor for esophageal squamous cell carcinoma (RR = 1.671, 95% CI: 1.212-2.306). [Conclusion] The high expression of MMP-9 gene in peripheral blood of patients with esophageal squamous cell carcinoma correlates with the metastasis of esophageal cancer and may indicate the poor prognosis of esophageal cancer patients.