摘要
目的:观察COX-2在大肠肿瘤不同发展阶段的表达,研究COX-2的表达与大肠肿瘤各临床病理特征之间的关系.方法:使用免疫组化染色法分别研究了76例外科手术切除的原发性大肠癌石蜡标本(早期大肠癌32例,进展期大肠癌44例)、33例大肠腺瘤、18例正常大肠黏膜活检组织中COX-2蛋白的表达;采用K-M半参数法和Cox模型分析COX-2蛋白的表达与进展期大肠癌预后的关系.结果:依表达程度由(-)至(++)四级计算,COX-2的表达率在正常结肠黏膜中分别为83.3%,16.7%,0%,0%;在结肠腺瘤中分别为12.1%,42.4%,36.4%,9.1%;早期结肠癌中分别为6.3%,28.1%,46.9%,18.7%;在进展期结肠癌中分别为6.8%,20.5%,18.2%,54.5%.除腺瘤组与早期癌组中COX-2的表达率无差别外,其余两两之间COX-2的表达率均有显著性差异(P<0.01).生存分析显示,COX-2高表达组与低表达组之间的生存曲线有显著性差异(P<0.05).Cox模型中单因素分析显示COX-2表达的死亡风险比为2.665(P<0.05);多因素分析显示COX-2表达是与进展期大肠癌术后患者预后相关的独立危险因素.结论:COX-2的表达在由正常大肠黏膜至大肠腺瘤和早期癌至进展期大肠癌发展过程中呈上调趋势.COX-2的表达是一种影响进展期大肠癌术后患者预后的独立危险因素.
AIM:To investigate the expression of COX-2 on different stages of colorectal cancer and the correlation between the expression of COX-2 and its clinicopathological features. METHODS:The expression of COX-2 was determined by immunohistochemical staining in seventy-six surgical specimens of colorectal cancer (late stage 44 and early stage 32), 33 adenomas and 18 normal colonic mucosal tissues were biopsied endocscopically. The correlation of COX-2 with the survival rate was evaluated with Kaplan-Meier survival curves and Cox proportional hazards regression. RESULTS:The degree of expression of COX-2 was categorized into 4 grades ranged from “-” to “+++”, the expression grades in series in normal colonic mucosal tissues was 83.3 %, 16.7 %,0 %,0 %, respectively; that in adenomas was 12.1 %, 42.4 %,36.4 %,9.1 %, respectively. The difference of the expression of COX-2 between late stage and early stage of colorectal cancer, and that between the late stage of cancer and adenoma were statistically significant (P <0.01); however, no significant difference in the expression of COX-2 between early stage of cancer and adenoma was observed. A significant difference in the survival curves between low COX-2 expression group and high COX-2 expression group was showed by Kaplan-Meier survival analysis (P <0.05). Cox proportional hazards regression indicated that the correlation of the expression of COX-2 with the poor long-term prognosis was existed with a hazard ratio of 2.665 unadjusted for other variables (P <0.05); the expression of COX-2 was an independent risk factor for poor prognosis. CONCLUSION:The expression of COX-2 is gradually up- regulated in the evolution of normal epithelium to adenomaor from early stage to advanced stage of colorectal cancer. The expression of COX-2 is an independent risk factor of poor prognosis for postoperative patients with advanced colorectal cancer.
出处
《世界华人消化杂志》
CAS
2003年第3期306-309,共4页
World Chinese Journal of Digestology
