The Expression Of Thymidine Phosphorylase And Matrix Metalloproteinase-9 In Gastric Carcinoma And Their Correlations With Angiogenesis And Clinical Outcome

objective The expression of thymidine phosphorylase (TP) and matrixmetalloproteinase-9 (MMP-9) in gastric carcinoma were examined to determine whether they are correlated with angiogenesis and clinical outcome of the desease.Methods The expression of TP, MMP-9 and microvessel density(MVD) weredetected by immunohistochemical techniques(S-P) in 20 specimens of normal gastric mucous and 60 specimens of gastric carcinoma from patients who underwent curative resection, and the expression of TP and MMP-9 were also examined both in 15 specimens of gastric carcinoma from patients who underwent non-curative resection and in 15 specimens of their correlative hepatic metastatic lesions. Correlations between the expression of TP, MMP-9 and MVD, as well as their correlations with the clinicopathologic factors, hepatic metastasis, and prognosis of the patients were evaluated statistically.Results (1) The positive expression rate of TP, MMP-9 in gastric carcinomafrom patients who underwent curative resection were 60.0% (36/60) and 75.0% (45/60) respectively, the mean vaule of MVD was 22.91±9.76. No correlation was observed between TP and MMP-9 expression. Both the expression of TP and MMP-9 were significantly correlated with angiogenesis. TP expression was associatied with lymph node metastasis and tumor stage, whereas MMP-9 expression or high MVD were associatied with depth of invasion, lymph node metastasis and tumor stage. Positive TP, MMP-9 expression or high MVD were all associatied with a poor survival, and positive expression of both TP and MMP-9 intumors conferred a poorer prognosis than negative expression of those factors in tumors, but only the lymph node metastasis and vascular grade were independent prognostic factors on multivariate analysis. (2) In 10 cases of gastric carcinoma with metachronous hepatic metastases, the positive expression rate of TP was 90.0% (9/10) , and that of MMP-9 was 100%(10/10). In 15 cases of gastric carcinoma with synchronous hepatic metastases, both TP and MMP-9 expressed in primary lesions, and MMP-9 expression was observed in all hepatic metastic lesions, while TP expression was detected in 12 out of 15 hepatic metastatic lesions. The ratio of liver metastasis in the patients whose MVD ^23 was higher than that of those MVD<23. TP and MVD were significantly associated with the risk of hepatic recurrence by multivariate analysis.Conclusions Both TP and MMP-9 are important for angiogenesis in gastriccarcinoma. TP and MMP-9 may affect the progression of tumor by promotion of angiogenesis. Expression of TP and MVD are effective predictors of hepatic recurrence. Determination of the TP status and the MVD may be valuable tools for prognostic evaluation and treatment planning in patients with gastric carcinoma.