| Objective:The gastric carcinoma is one of the most common malignant tumors in our country. The rate of incidence and death is the highest in all kinds of the alimentary tract malignant tumors. The invasion and metastasis of tumor cells are the major reasons for the poor prognosis of the patients with gastric carcinoma. On the clinic, although about 60% patients with gastric carcinoma are through the valid treatment, they died of the invasion and metastasis of tumor cells. So the studies of the mechanism of the invasion and metastasis about gastric carcinoma have become the focus at present. Many studies discovered that the invasion and metastasis of gastric carcinoma was a complicated process of many steps and stages, involved to various factors. Degradation of the extracellular matrix (ECM) is a very important step. The breakage of the integrity of ECM or not is closely related to invasion, distant metastasis and poor prognosis. As the most important enzyme that degradation of the composition of ECM, matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) play important roles in this process. MMPs almost can degrade the all composition of ECM and blood vessel's base mucosa, thus accelerating the invasion and metastasis of tumor cells. TIMPs are the major natural inhibitors of MMPs. By inhibiting MMPs, TIMP-2 can inhibit the invasion and metastasis of tumor cells. The dynamic equilibrium of the expressions level of MMPs and TIMPs decide the degree of the ECM's degradation, and also decide the invasion and metastasis of tumor cells. The expressions of MMPs and TIMPs have become the new target of the anti-tumor medicine, and also become the hotspot of the studies of the invasion and metastasis of tumor cells in recent years. But now there are little reports about the relationship between the expressions of MMP-2 and TIMP-2 in gastric carcinoma and regional lymph node tissues and the prognosis. Therefore, in this study we detect the expressions of MMP-2 and TIMP-2 in gastric carcinoma tissues,regional lymph node tissues and normal gastric mucosa by S-P immunohistochemical technique, analyze the relationship between the expressions and the ability of invasion and metastasis of tumor cells, the relationship between the expressions and the biological behavior of gastric carcinoma (including tumor location,size,Borrmann's type,differentiation degree,the depth of invasion,lymph node metastasis and TNM stage etc.) and the relationship between the expressions and the prognosis. So we can provide the theoretical foundation for prognosticating the invasion and metastasis of gastric carcinoma,evaluating the prognosis and guiding the reasonable comprehensive treatment.Methods:In this study, we select 68 samples of gastric carcinoma, 68 samples of regional lymph node and 30 samples of normal gastric mucosa, which proved by pathology. All patients had radical gastrectomy in the third department of surgery of the 4th hospital of HeBei Medical University from January 1992 to June 1994. All gastric carcinoma clinical records registered according to gastric carcinoma treatment criterion. All cases follow up over 5 years. The expressions of MMP-2 and TIMP-2 in gastric carcinoma tissues,regional lymph node tissues and normal gastric mucosa were detected by S-P immunohistochemical technique in this study. The relationship between the expressions of MMP-2 and TIMP-2 and the biological behavior of gastric carcinoma were analyzed, including patients'sex,age,tumor location,size,Borrmann's type,differentiation degree,the depth of invasion,lymph node metastasis and TNM stage etc. And the relationship between the expressions of MMP-2 and TIMP-2 and the prognosis were studied. All data are analyzed by statistics software SPSS 10.0. Results: 1.The expressions of MMP-2 in gastric carcinoma tissues are significantly higher than those in normal gastric mucosa (P<0.05). The expressions of TIMP-2 in gastric carcinoma tissues are lower than those in normal gastric mucosa, but no difference significantly (P>0.05). 2.In gastric regional lymph node tissues, the expressions of MMP-2 in the group with lymph node metastasis aresignificantly higher than that without lymph node metastasis (P<0.01). The expressions of TIMP-2 in the group with lymph node metastasis are significantly lower than that without lymph node metastasis (P<0.05). The rate of lymph node metastasis in positive expressions group of MMP-2 is significantly higher than that in negative one (P<0.01). The rate of lymph node metastasis in positive expressions group of MMP-2 is significantly lower than that in negative one (P<0.05). 3.The expressions of MMP-2 and TIMP-2 in gastric carcinoma tissues show no difference in patients'sex, age, tumor location and size (P>0.05). 4.The expressions of MMP-2 in gastric carcinoma tissues become significantly higher along with differentiation degree to lower, the depth of invasion to deeper, lymph node metastasis, TNM stage to higher (P<0.05). The expressions of TIMP-2 in gastric carcinoma tissues become significantly lower along with differentiation degree to lower, the depth of invasion to deeper, lymph node metastasis, TNM stage to higher (P<0.01 or P<0.05). 5.In gastric carcinoma tissues, 5-year survival rate in positive expressions group of MMP-2 is significantly lower than that in negative one (P<0.01). 5-year survival rate in positive expressions group of TIMP-2 is significantly higher than that in negative one (P<0.01). 6.In gastric regional lymph node tissues, 5-year survival rate in positive expressions group of MMP-2 is significantly lower thanthat in negative one (P<0.05). 5-year survival rate in positive expressions group of TIMP-2 is significantly higher than that in negative one (P<0.05). 7.The expressions of MMP-2 and TIMP-2 have negative correlation in gastric carcinoma tissues (r = ? 0.268, P<0.05). Conclusion: 1.The expressions of MMP-2 in gastric carcinoma tissues are significantly higher than those in normal gastric mucosa. The expressions of TIMP-2 in gastric carcinoma tissues are lower than those in normal gastric mucosa. It shows the molecular biology factors have changed which are correlated with degradation of the ECM. It establishes the foundation for the invasion and metastasis of gastric carcinoma. 2.The expressions of MMP-2 in gastric carcinoma tissues become significantly higher along with differentiation degree to lower, the depth of invasion to deeper, lymph node metastasis, TNM stage to higher. The expressions of TIMP-2 in gastric carcinoma tissues become significantly lower along with differentiation degree to lower, the depth of invasion to deeper, lymph node metastasis, TNM stage to higher. It shows the expressions of MMP-2 and TIMP-2 are correlated with clinical pathology progress of gastric carcinoma. It indicates the ability of the invasion and metastasis of gastric carcinoma become higher, and the ability of local anti-invasion and anti-metastasis become lower, which the high expression of MMP-2 and the low expression of TIMP-2.3.The expressions of MMP-2 and TIMP-2 in gastric carcinoma tissues show no difference in patients'sex, age, tumor location and size. 4.In gastric carcinoma tissues, 5-year survival rate in positive expressions group of MMP-2 is significantly lower than that in negative one. 5-year survival rate in positive expressions group of TIMP-2 is significantly higher than that in negative one. It shows the expressions of MMP-2 and TIMP-2 in gastric carcinoma is one of the important biological factors influencing the prognosis. 5.In gastric carcinoma tissues, the expressions of MMP-2 and TIMP-2 have negative correlation. It shows the expressions of MMP-2 and TIMP-2 in gastric carcinoma have the antagonism in invasion and metastasis of gastric carcinoma. 6.In gastric regional lymph node tissues, the expressions of MMP-2 in the group with lymph node metastasis are significantly higher. The expressions of TIMP-2 in the group with lymph node metastasis are significantly lower. In gastric regional lymph node tissues, the rate of lymph node metastasis in positive expressions group of MMP-2 is significantly higher. The rate of lymph node metastasis in positive expressions group of TIMP-2 is significantly lower. It shows the expressions of MMP-2 and TIMP-2 in gastric regional lymph node tissues unusually are correlated with lymph node metastasis. In gastric regional lymph node tissues, which the high expression of MMP-2 and the low expression of TIMP-2, it is easy to take...
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