天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (1): 38-42.doi: 10.11958/20181302

• 临床研究 • 上一篇    下一篇

MMP-7在胆道闭锁肝纤维化患者中的表达及临床意义

余晨 1，熊希倩 1，詹江华 2△，胡晓丽 3，高伟 4   

  1. 基金项目：国家自然科学基金资助项目（81570471）；天津市卫生行业重点攻关项目（14KG129） 作者单位：1天津医科大学研究生院（邮编300070）；2天津市儿童医院普外科，3病理科；4天津市第一中心医院移植科 作者简介：余晨（1992），女，硕士在读，主要从事儿童先天性胆道闭锁方面研究 △通讯作者 E-mail: zhanjianghuatj@163.com
  • 收稿日期:2018-08-31 修回日期:2018-11-17 出版日期:2019-01-15 发布日期:2019-01-15
  • 通讯作者: 詹江华 E-mail:zhanjianghuatj@163.com
  • 基金资助:
    天津市卫生行业重点攻关项目;国家自然科学基金

Expression and clinical significance of MMP-7 in hepatic fibrosis of biliary atresia

YU Chen1, XIONG Xi-qian1, ZHAN Jiang-hua2△, HU Xiao-li3, GAO Wei4   

  1. 1 Graduate School of Tianjin Medical University, Tianjin 300070, China; 2 Department of Surgery, 3 Department of Pathology ,Tianjin Children’s Hospital; 4 Department of Transplantation Surgery, Tianjin First Central Hospital △Corresponding Author E-mail: zhanjianghuatj@163.com
  • Received:2018-08-31 Revised:2018-11-17 Published:2019-01-15 Online:2019-01-15
  • Contact: zhanjianghua E-mail:zhanjianghuatj@163.com

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摘要： 目的 研究基质金属蛋白酶7（MMP-7）与胆道闭锁（BA）患者肝纤维化分级、胆管反应程度之间的关系， 探索其在肝纤维化进程中的作用及临床意义。方法 选取2017年6月—2018年4月我院收治的15例胆道闭锁患儿 行Kasai手术时的肝活检组织（G1组），另选取2015年1月—2016年1月因行Kasai术后肝脏功能衰竭而行肝移植术 的病肝组织41例（移植组），将移植组按Kasai手术与肝移植的间隔时间分为2组：G2组（28例，间隔时间＜2年）和G3 组（13例，间隔时间≥2年）。采用HE染色观察3组患者肝脏纤维化程度，免疫组化染色检测MMP-7和CK-19蛋白在 肝脏中的表达情况并进行半定量分析。结果 （1）免疫组化结果显示，MMP-7主要表达于胆管上皮细胞、增生的胆 管、汇管区周围肝细胞，随着肝纤维化程度进展，胆管细胞及肝细胞MMP-7表达强度增加，且胆管细胞比肝细胞表达 更为强烈。MMP-7在G1~G3组中的表达水平分别为（0.068±0.017）vs（. 0.093±0.017）vs（. 0.084±0.016），差异有统计学 意义（F=10.541，P＜0.001），CK-19在3组的表达水平分别为（0.119±0.036）vs（. 0.157±0.040）vs（. 0.110±0.044），差异有 统计学意义（F=7.296，P＜0.001），G2组MMP-7、CK-19蛋白表达水平明显高于其余2组（P＜0.05），G1组与G3组之 间差异无统计学意义（P＞0.05）。（2）3组的肝纤维化程度分别为2（2，3）vs. 4（3，4）vs. 4（2，4）（H=17.785，P＜0.001）， G2组纤维化程度明显高于其余2组，差异具有统计学意义（P＜0.017）。（3）相关性检验示：MMP-7蛋白表达量与肝纤 维化程度呈弱正相关（rs=0.609，P＜0.001），但与胆管反应程度（CK-19）无明显线性相关性（r=0.007，P=0.962）。结 论 MMP-7在BA患儿Kasai术后肝组织中高表达，并且随肝纤维化程度加重而表达升高，其可能参与并促进了BA 肝纤维化进程，提示自体肝生存不佳。

关键词: 胆道闭锁, 肝硬化, 基质金属蛋白酶7, 自体肝生存

Abstract: Objective To investigate the relationship of matrix metalloproteinase-7 (MMP-7) in liver tissue of biliary atresia (BA) with liver fibrosis and bile duct reaction, and explore the role of MMP-7 in the process of liver fibrosis and its clinical significance. Methods Data of 15 BA patients with liver biopsy in Kasai operation in our hospital from June 2017 to April 2018 were collected (G1 group)，and data of 41 patients with liver biopsy who underwent liver transplantation after Kasai operation from January 2015 to January 2016 were enrolled as transplantation group. The transplantation group was divided into two groups according to the interval time between Kasai operation and liver transplantation: G2 group (n=28, the interval time was less than 2 years) and G3 group (n=13, the interval time was more than 2 years). Hematoxylin-Eosin (HE) staining was used to observe the degree of liver fibrosis. Immunohistochemical staining was used to detect the expressions of MMP-7 and CK-19. Results (1) Immunohistochemical results showed that MMP-7 was mainly expressed in bile duct epithelial cells, hyperplastic bile ducts and hepatocytes around the portal area. With the progress of hepatic fibrosis, the expressions of MMP-7 were increased in biliary duct cells and hepatocytes, and which were strongly expressed in biliary duct cells than those of hepatocytes. Semi-quantitative analysis showed that the expression levels of MMP-7 were (0.068± 0.017) vs. (0.093±0.017) vs. (0.084±0.016) in the three groups (F=10.541，P＜0.001). CK-19 staining showed that bile duct reactions of three groups were (0.119±0.036) vs. (0.157±0.040) vs. (0.110±0.044) (F=7.296，P＜0.001). The expression levels of MMP-7 and CK-19 protein were significantly higher in G2 group than those of other two groups (P＜0.05). There was no significant difference between G1 and G3 groups (P＞0.05). (2) The liver fibrosis in the three groups were 2 (2, 3) vs. 4 (3, 4) vs. 4 (2, 4) (H=17.785, P＜0.001), and the fibrosis was significantly higher in the G2 group than that of other two groups (P＜ 0.017). (3) Correlation test showed that the expression of MMP-7 protein was positively correlated with the degree of liver fibrosis (rs=0.609, P＜0.001), but there was no correlation with bile duct reaction (r=0.007, P=0.962). Conclusion The expression of MMP-7 protein is highly expressed in liver tissue after Kasai operation, and it increases with the severity of liver fibrosis. MMP-7 may participate in the process of BA liver fibrosis and suggest that the survival of autologous liver is poor.

Key words: biliary atresia, liver cirrhosis, matrix metalloproteina-7, native liver survival