자궁경부암에서 기저막 단백분해 저해효소 (TIMP-2)의발현에 대한 연구
Expression of the Tissue Inhibitor of Matrix-Metalloproteinase (TIMP-2)in Cervical Carcinoma
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목적 : 본 연구는 종양의 증식, 침윤 및 전이를 유발하는 기저막 단백분해 저해효소 (TIMP-2)의 자궁경부암에서의 발현과 재발과의 상관관계를 알아보고자 하였다. 연구 방법 : 자궁경부암으로 진단되어 자궁적출술을 시행받거나 재발성 자궁경부암으로 진단되어 수술이나 조직검사를 시행 받은 33예와 정상 자궁경부 조직 10예를 대상으로 면역조직화학 염색을 이용하여 TIMP-2의 발현을 분석하고 예후인자와의 상관관계를 분석하였다. 결과 : 종양세포에서의 발현에 대한 분석에서 종양의 크기, 침윤 정도, 조직학적 유형에 따른 차이는 없었고, 림프절 전이 군, 림프혈관 침윤 군에서 낮은 발현 경향을 보였으나 통계적인 유의성이 없었다 (p>0.05). 재발한 군 (0.78±0.44)에서도 재발하지 않은 군 (0.91±0.29)에 비해 낮은발현율을 보였으나 통계적인 유의성이 없어 (p=0.314) 종양세포에서의 TIMP-2의 발현과 림프절 전이, 림프혈관 침윤, 재발과는 유의한 상관 관계가 없음을 확인하였다. 그러나 종양주변 간질세포에서의 발현에 대한 분석에서 종양의 침윤이 <5 mm 군에서 종양의 침윤이 ≥5 mm 군에 비해 낮게 발현되는 경향을 보였으나 통계적인 유의성은 없었지만 (p>0.05), 재발한 군(0.33±0.50)에서는 재발하지 않은 군 (0.83±0.39)에 비해 낮은 발현율을 보여 (p=0.006) 재발과의 역 상관 관계를 보였다. 결론 : 자궁경부암의 종양세포에서 TIMP-2의 발현은 자궁경부암의 예후인자인 침윤 정도, 종양의 크기, 림프절 전이 유무, 림프혈관 침윤 유무 및 재발과 유의한 상관 관계가 없었으나, 자궁경부암의 간질세포에서의 TIMP-2의 발현은 재발과 유의한 역 상관 관계가 있음을 확인할 수 있었다.
Abstract
Objective : The present study was conducted to evaluate the tissue inhibitor of matrix-metalloproteinase (TIMP-2), which leads to tumor proliferation, invasion and metastasis and which can be used as a prognostic factor for cervical carcinoma, and to correlate TIMP-2 with recurrence in cervical carcinoma. Methods : Thirty-three cases of cervical carcinoma and ten control cervices were analysed for expression of TIMP-2 by immunohistochemical staining. Results were analysed for possible correlation with prognostic factors. Results : Lymph node metastasis, lymphovascular invasion, and recurrence groups showed a lower expression tendency of TIMP-2 in tumor cells (0.67 vs 0.88, 0.77 vs 0.93, 0.78 vs 0.91) (p>0.05). However, there was no statistical significance in the correlation of TIMP-2 expression with tumor variables. On the other hand, in stromal cells, deep invasion (≥5 mm), squamous cell carcinoma groups showed a higher expression tendency of TIMP-2 (0.80 vs 0.67, 0.74 vs 0.40) (p>0.05) but, there was no statistical significance. However, recurrence group showed a significantly lower expression of TIMP-2 in stromal cells (0.33 vs 0.83) (p<0.05). Conclusion : In spite of no statistically significant correlation in tumor cells, recurrence group showed a significantly lower expression of TIMP-2 in stromal cells. Therefor there was an inverse correlation between expression of TIMP-2 in stromal cell and recurrence. These results indicate that expression of TIMP-2 in stromal cells is closely correlated with the recurrence of cervical carcinoma.
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