探讨肿瘤转移抑制基因KiSS-1与肿瘤转移相关基因MTA1在卵巢上皮性肿瘤中的表达及其临床意义。

选择1994年1月至2003年12月在哈尔滨医科大学附属第三医院和牡丹江医学院附属红旗医院进行卵巢肿瘤切除术的121例卵巢肿瘤患者为研究对象。采用免疫组织化学SP法检测受试者切除卵巢肿瘤组织中KiSS-1及MTA1的表达，并统计学比较二者在不同病理类型卵巢上皮性肿瘤中的表达阳性率差异，在卵巢上皮性癌的不同临床病理参数下表达阳性率差异，以及在卵巢上皮性癌中表达的相关性及其表达与卵巢上皮性癌患者5年生存率之间的关系。

①卵巢良性上皮性肿瘤及卵巢交界性上皮性肿瘤细胞质中，KiSS-1表达阳性率均显著高于卵巢上皮性癌，且差异均有统计学意义(83.3% vs 29.5%，χ²＝23.375，P＝0.000 1；63.3% vs 29.5%，χ²＝29.536，P＝0.000 2)；而卵巢良性上皮性肿瘤及卵巢交界性上皮性肿瘤细胞质中，MTA1表达阳性率均显著低于卵巢上皮性癌，且差异均有统计学意义(23.3% vs 73.8%，χ²＝20.889，P＝0.000 4；40.0% vs 73.8%，χ²＝9.800，P＝0.002 0)。② KiSS-1或MTA1在卵巢上皮性癌的国际妇产科联盟(FIGO)临床分期、淋巴结转移及腹水等临床病理参数下的表达阳性率比较，差异均有统计学意义(P<0.05)；而在年龄、肿瘤直径、组织学类型及世界卫生组织(WHO)病理分级的临床病理参数下，表达阳性率比较，差异均无统计学意义(P>0.05)。③ KiSS-1和MTA1在卵巢上皮性癌中的表达呈负相关关系(r＝－0.268，P＝0.038)。④在卵巢上皮性癌中，KiSS-1表达呈阳性者的5年生存率(33.3%)显著高于KiSS-1表达呈阴性者(14.0%)，而MTA1表达呈阳性者的5年生存率(11.1%)显著低于MTA1表达呈阴性者(43.8%)，且差异均有统计学意义(χ²＝6.473，14.869；P<0.05)。

KiSS-1与MTA1基因可能参与了卵巢上皮性肿瘤的发生、发展和转移过程，或可作为评估恶性上皮性卵巢肿瘤预后的可行性指标。

To investigate the expression and clinical significance of tumor metastasis suppressor gene KiSS-1 (KiSS-1) and metastasis associated gene 1(MTA1) in epithelial ovarian tumor.

A total of 121 ovarian tumor patients who were underwent ovarian tumor resection in the Third Hospital Affiliated to Harbin Medical University and Hongqi Hospital Affiliated to Mudanjiang Medical School from January 1994 to December 2003 were chosen as research objects. Histochemical technique was used to detect the KiSS-1 and MTAl protein expression levels in 121 ovarian tumor samples. Statistical method was used to compare the differences of expression positive rates of KiSS-1 and MTA1 in different pathological types of epithelial ovarian tumors and in different clinical pathological parameters of ovarian epithelial carcinoma, also the correlation of expression levels of these two proteins in ovarian epithelial carcinoma and the relationship between their expression level and five year survival rate of ovarian epithelial carcinoma.

① Expression positive rates of KiSS-1 in benign ovarian epithelial and borderline of epithelial ovarian tumors in cytoplasm were both higher than that of in ovarian epithelial carcinoma, and the differences were statistically significant(83.3% vs 29.5%, χ²=23.375, P=0.000 1; 63.3% vs 29.5%, χ²=29.536, P=0.000 2); However, expression positive rates of MTA1 in benign ovarian epithelial and borderline of epithelial ovarian tumors in cytoplasm were both lower than that of in ovarian epithelial carcinoma, and the differences were statistically significant(23.3% vs 73.8%, χ²=20.889, P=0.000 4; 40.0% vs 73.8%, χ²=9.800, P=0.002 0). ② There were significant differences of KiSS-1 or MAT1 expression positive rate in clinical pathological parameters of International Federation of Gynecology and Obstetrics(FIGO) clinical stage, lymph node metastasis and ascites(P<0.05), but there were no significant differences in clinical pathological parameters of age, tumor size, histological types and the WHO pathological grades(P>0.05). ③ The expression of KiSS-1 and MTA1 in ovarian epithelial carcinoma were negatively correlation(r=-0.268, P=0.038). ④ In ovarian epithelial carcinoma, 5 year survival rate of KiSS-1 positive patients(33.3%) was higher than that of KiSS-1 negative ones(14.0%), While, 5 year survival rate of MTA1 positive patients(11.1%) was lower than that of MAT1 negative ones(43.8%), and the differences were statistically significant(χ²=6.473, 14.869; P<0.05).

The expressions of KiSS-1 and MTA1 gene may participate in carcinogenesis, invasion and metastasis of epithelial ovarian tumor, which may contribute to prognosis marker of malignant epithelial ovarian tumor.