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Expression and clinical significance of heparanase in metastatic lymph nodes of cervical squamous carcinoma

LU Shu-fang, HU Bin, LI Yuan-kun, ZHOU Xin-huan, CUI Jin-quan   

  1. Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China
  • Online:2013-09-28 Published:2013-09-29
  • Supported by:

    Key Grant of Henan Provincial Education Department, 12A320024

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Abstract:

Objective To detect the expression of heparanase (HPA) in metastatic lymph nodes, and investigate its role in the diagnosis of lymph node metastasis of cervical squamous carcinoma. Methods The expression of HPA in cervical squamous carcinoma with lymph node metastasis (group A) and cervical squamous carcinoma without lymph node metastasis (group B) was detected by immunohistochemical S-P method. Primary foci, metastatic lymph nodes and non-metastatic lymph nodes were selected for group A, and primary foci and non-metastatic lymph nodes for group B. Image analysis technique was employed to determine the average gray values and positive units of expression of HPA, and CK19 was a marker of squamous epithelia. Results In group A, the average gray values of HPA in primary foci, metastatic lymph nodes and non-metastatic lymph nodes gradually increased, and the positive units of HPA gradually decreased, with significant differences (P=0.000). In group B, the average gray value of HPA in primary foci was significantly lower than that in lymph nodes (P=0.000), and the positive unit of HPA in primary foci was significantly higher than that in lymph nodes (P=0.037). The expression rate of HPA in lymph node was significantly related to clinical stage (P=0.013), differentiation (P=0.000) and lymph node metastasis (P=0.000). The median overall survival (MOS) of all patients was 49.0 months, and MOS of patients with lymph node metastasis (36.0 months) was significantly lower than that of patients without lymph node metastasis (58.5 months) (P=0.023). MOS of patients with HPA positive lymph nodes (38.5 months) was significantly lower than that of patients HPA negative lymph nodes (57.0 months)(P=0.040). Cox regression analysis revealed that lymph node metastasis and expression HPA were independent risk factors for prognosis of cervical cancer (P<0.05). Conclusion HPA may be an important biomarker of lymph node metastasis of cervical squamous carcinoma, and patients with HPA positive lymph nodes may have poorer prognosis.

Key words: cervical cancer, heparanase, CK19, lymph node, prognosis