The Clinical Value And Expression Of Matrix Metalloproteinase-7, Survivin In Bronchial Lavage Fluid In Lung Cancer

ObjectiveTo study the expression of matrix metalloproteinase-7(MMP-7), survivin messenger RNA(mRNA) in specimen from bronchial lavage fluid(BLF) of lung cancer, and to study the correlation between expression of MMP-7, survivin and clinical features and different bronchial lavage sequences as well. To explore the clinical value of MMP-7 mRNA, survivin mRNA in BLF specimens as tumor makers for earlier diagnosis of lung cancer, especialy peripheral lung cancer.MethodsBronchial lavage fluid(BLF) were collected from 124 cases suffering from lung cancer, 103 cases suffering from pulmonary benign diseases. Forceps biopsy(FB) were collected from 42 cases suffering from lung cancer, 30 cases suffering from pulmonary benign diseases. All specimens were deteced the expression of MMP-7, survivin messenger RNA(mRNA) with the method of reverse polymerase chain reaction(RT-PCR). The expression of MMP-7 mRNA, survivin mRNA in patients with lung cancer and non-lung cancer, the correlation between expression of MMP-7 mRNA, survivin mRNA and clinical features, different bronchial lavage sequences were studied. The results were compared with their cytopathological examinations. The clinical value of MMP-7 mRNA, survivin mRNA in BLF specimens as specific tumor makers for earlier diagnosis, especialy peripheral lung cancer was evaluated by ROC (receiver operating characteristic curve) analytical system.Results1. To detect MMP-7 mRNA,survivin mRNA expression in patients with lung cancer and non-lung cancer the consistencies were better in paired specimens FB and BLF(Kappa=0.419, 0.567; P=0.001, 0.000). 2. The positive rate of survivin mRNA in specimen from BLF of lung cancer 45.2%(56/124) was higher than that 18.4%(19/103) in specimen from BLF of non-lung cancer, and there was significant difference between the positive rate of survivin mRNA in specimen from BLF of lung cancer and that in specimen from BLF of non-lung cancer(χ2=18.150, P=0.000), but there was no significant difference between the positive rate of MMP-7 mRNA in specimen from BLF of lung cancer 24.2%(30/124) and that 18.4%(19/103) in specimen from BLF of non-lung cancer(χ2=1.098, P=0.295).3. There were correlation between survivin expression and histopathological subtype(small cell lung cancer), differentiation(lower differentiation), T of TNM stages(all P<0.05). There was correlation between MMP-7 mRNA expression and smoking(P<0.05).4. There was no difference between the positive rate of cytopathological examination (23.9%) and that (22.1%) of MMP-7 mRNA (χ2=0.100,P=0.752), while there were significant difference between the positive rate of cytopathological examination and that (43.4%) of survivin mRNA, that (51.3%) MMP-7 mRNA combined with survivin mRNA from BLF specimens (χ2=9.595, 18.121; P=0.002, 0.000 ). The positive rates of MMP-7 mRNA, survivin mRNA and MMP-7 mRNA combined with survivin mRNA from BLF specimens were 24.2%(21/124), 44.2%(38/86), 59.3%(51/86) respectively, while the positive rate of cytopathological examinations from BLF specimens was zero. The sensitivity of cytological examinations combined with detecting MMP-7 mRNA, survivin mRNA from BLF specimens was higher than that of either cytological examination or MMP-7 mRNA, survivin mRNA detection of BLF specimens alone(all P<0.05).5. The sensitivity and specificity of the diagnosis for lung cancer by detecting MMP-7 mRNA, survivin mRNA, MMP-7 mRNA combined with survivin mRNA in BLF specimens were respectively: 24.2%, 45.2%, 52.4% and 81.6%, 81.6%, 97.1%. The sensitivity and specificity of the diagnosis for peripheral lung cancer by detecting MMP-7 mRNA, survivin mRNA, MMP-7 mRNA combined with survivin mRNA from BLF specimens were respectively: 23.1%, 35.9%, 43.6% and 85.4%, 85.4%, 98.1%. ConclusionsConclusions drawn from this study are as following:1. Expression of survivin mRNA in specimens from bronchial lavage fluid(BLF) might be used as the specific molecular markers for diagnosis of lung cancer especially peripheral lung cancer because of it,s higher sensitivity and specificity. The diagnosis value of expression of MMP-7 mRNA in specimens from BLF should be studied further for it's lower sensitivity and poor consistency.2. It can make the diagnosis sensitivity for lung cancer especialy peripheral lung cancer improved greatly that detecting cytological examination combined with survivin mRNA, or, and with MMP-7 mRNA, and that detecting survivin mRNA combined with MMP-7 mRNA.3. The outcome of expression of MMP-7 mRNA, survivin mRNA don't be affected by the different bronchial lavage sequences.