The Expression Of Ki-67,MMP-2 And VWF In Rectal Carcinoma And Their Significance As Prognostic Marks

Background: Rectal cancer is a common malignant tumor. The impact factors on the prognosis of the patient with rectal cancer are complex and it is very difficulty to predict the prognosis of the patient. To study the expression of biological molecular correlated to proliferation and invasion and metastasis in the rectal carcinoma is very significance to explore their role in the regenesis and progression of rectal cancer and look for the marks for predicting the prognosis of patients. Ki-67 is a proliferation associated nuclear antigen and play a critical role in the regulation of cell division cycle. Ki-67 is detectable in all active parts of cell cycle, but not in resting cell (Go), therefore it is widely used as a proliferation mark to measure the growth fraction of cells in human tumors and culture cell. MMP-2 (matrix metalloproteinase-2) can specially solve type IV collagen which is the main content of extra cellular matrix and basement membrane; there it is the key enzyme in the invasion and metastasis. Angiogenesis is necessary for the progression and metastasis in carcinoma. vWF (von Willebrend factor) is a glucoprotein secreted by endothelial cells and macromonocyte, can be identified in the plasma, the membrane of endotheliocyte. vWF is related to angiogenesis and is the marker of novel angiogenesis. But little isknown of the expression of Ki-7 MMP-2 and vWF in the rectal cancer and their role in regenesis and progression of rectal cancer.Objectives: To study the expression of Ki-7 MMP-2 and vWF in rectal carcinoma and matched normal tissue, explore the correlations of the expression of Ki-67 MMP-2 and vWF with the regenesis and progression of rectal cancer and the significance of Ki-67 MMP-2 and vWF as prognostic marks for the patients with rectal cancerMaterials and Methods: A total of 82 rectal carcinoma and 15 matched normal tissue were obtained from patients with rectal cancer who had operation and without chemotherapy and radiotherapy before operation in the First Affiliated Hospital of Medical College, Zhejiang University in the period from April 1997 to February 1999, and had been followed up by us. Eighty two patients were 30 to 79 age years, the mean age of them was 58.4±11.5 age years. The expression of ki-67 MMP-2 and vWF in rectal carcinoma and matched normal tissues were examined by immunohisochemistry (Envision) stain method and analyzed. The correlations of the expression with the differentiation, invasion and metastasis and various clinicopathological features were analyzed. The correlations of ki-67 MMP-2and vWF expression intensity with the survival time of patients were analyzed retrospectively use Wilcoxon- Gehan survival statistics method. All statistic analysis performed by software SPSS 10.0.Results : 1. The Ki-67 LI in rectal carcinoma was 34. 0±7.7, significant higher than in matched normal tissues 17.5±7.1 (t=7.684, P<0.05). Ki-67 LI in poorly differentiated carcinoma was 38.8±5.7, significantly higher than in well and the moderately differentiate 33.0±7.8 (t=2.692, P<0.05), Ki-67 LI in the carcinoma in Dukes C and Dukes D stage was 36.9±6.9, significant higher than 30.8±7.4 in the Dukes A and Dukes B stage carcinoma (t=3.818, P<0.05). The survival time of thepatients with Ki-67-LI more than mean value (34. 0) was significant shorter than the patients with Ki-67 LI lower than or equal to the mean value (P< 0.05).2. The ratio of the higher MMP-2 expression to the lower expression in rectal carcinoma was 38/44, significant higher than 1/14 in matched normal tissues (P< 0.05). The ratio of the higher MMP-2 expression to the lower expression in carcinoma with invasion of extra-membrane or outside was 27/22, significant higher than 11/22 in the carcinoma without invasion of extra-membrane (P<0.05). The ratio in Dukes C and D stage was 25/18, significant higher than13/26 in Dukes A and B stage (P< 0.05). The survival time of the patients with higher MMP-2 expression was significant shorter than the patients with lower MMP-2 expression (P= 0.05).3. v WF- MVD in rectal carcin...