摘要
目的探讨直肠癌组织中环氧合酶-2(COX-2)和Ki-67的表达情况及其对新辅助放化疗(NAC)敏感性的预测价值。方法回顾性分析2021年6月至2022年9月南京中医药大学附属南京医院(南京市第二医院)收治的87例行直肠癌术前放化疗患者的临床资料。另选择南京中医药大学附属南京医院(南京市第二医院)病理科40例正常直肠组织标本作为对照,采用免疫组织化学法检测直肠癌患者肿瘤组织、癌旁组织和正常直肠组织中COX-2、Ki-67的表达。根据是否对放化疗敏感将患者分为放化疗敏感组(n=62)和放化疗不敏感组(n=27)。分析肿瘤组织及癌旁组织中COX-2、Ki-67的表达与放化疗敏感性的关系;采用logistic回归分析影响直肠癌患者放化疗效果的相关因素;绘制受试者操作特征曲线(ROC),以曲线下面积(AUC)评估直肠癌患者肿瘤组织中COX-2和Ki-67的表达对新辅助放化疗敏感性的预测价值。结果87例直肠癌患者中对放化疗敏感60例,敏感率为68.97%。肿瘤组织、癌旁组织中COX-2、Ki-67阳性表达率显著高于正常直肠组织(χ^(2)=53.187、7.131、53.047、14.613,P<0.05);肿瘤组织中COX-2、Ki-67阳性表达率显著高于癌旁组织(χ^(2)=72.572、67.616,P<0.05)。放化疗敏感组患者肿瘤组织中COX-2和Ki-67阳性表达率显著低于放化疗不敏感组(χ^(2)=3.965、6.264,P<0.05)。Logistic回归分析结果显示,肿瘤组织中COX-2、Ki-67表达阳性为影响直肠癌患者对新辅助放化疗效果的因素(P<0.05)。ROC曲线分析结果显示,肿瘤组织中COX-2、Ki-67表达及二者联合预测患者对新辅助放化疗敏感性的灵敏度分别为100.00%、100.00%、100.00%,特异度分别为13.33%、20.00%、31.67%,AUC分别为0.567、0.600、0.658。结论肿瘤组织中COX-2、Ki-67表达阳性为影响直肠癌患者新辅助放化疗效果的因素,联合检测COX-2、Ki-67表达对新辅助放化疗敏感性的预测价值较高。
Objective To investigate the expression of cyclooxygenase-2(COX-2)and Ki-67 in rectal cancer tissues and their predictive value for the sensitivity to neoadjuvant chemoradiotherapy(NAC).Methods The clinical data of 87 patients receiving chemoradiotherapy before rectal cancer surgery at Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine(the Second Hospital of Nanjing)from June 2021 to September 2022 were retrospectively analyzed.In addition,40 normal rectal tissue samples were selected from the Department of Pathology of Nanjing University of Chinese Medicine(the Second Hospital of Nanjing)as control.The expression levels of COX-2 and Ki-67 in tumor and adjacent tissues of patients with rectal cancer as well as in normal rectal tissues were detected by using the immunohistochemical method.The patients were divided into chemoradiotherapy-sensitive group(n=62)and chemoradiotherapy-resistant group(n=27)according to whether they were sensitive to chemoradiotherapy.The correlation between the expression levels of COX-2,Ki-67 in tumor tissues and adjacent tissues and the sensitivity to chemoradiotherapy was analyzed.The relative factors affecting the effect of chemoradiotherapy on rectal cancer patients were analyzed by using the logistic regression model.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was used to evaluate the predictive value of COX-2 and Ki-67 expression levels in tumor tissues of rectal cancer patients for the sensitivity to NAC.Results Among the 87 patients with rectal cancer,60 patients were sensitive to chemoradiotherapy,with a sensitivity rate of 68.97%.The positive expression rates of COX-2 and Ki-67 in tumor tissues and adjacent tissues were significantly higher than those in normal rectal tissues(χ^(2)=53.187,7.131,53.047,14.613;P<0.05).The positive expression rates of COX-2 and Ki-67 in tumor tissues were significantly higher than those in adjacent tissues(χ^(2)=72.572,67.616;P<0.05).The positive expression rates of COX-2 and Ki-
作者
付鲁渝
熊志强
张杰东
刘兰侠
刘杜先
FU Luyu;XIONG Zhiqiang;ZHANG Jiedong;LIU Lanxia;LIU Duxian(Department of Pathology,Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine(the Second Hospital of Nanjing),Nanjing 210003,Jiangsu Province,China)
出处
《新乡医学院学报》
CAS
2024年第11期1038-1042,共5页
Journal of Xinxiang Medical University
