卵巢上皮性癌组织中环氧合酶2的表达与治疗反应和预后的相关性研究

Relationship of cyclooxygenase 2 expression and chemotherapy response and prognosis in human ovarian carcinoma

目的 探讨卵巢上皮性癌组织中环氧合酶2(COX-2)的表达与卵巢上皮性癌患者治疗反应和预后的关系。方法采用免疫组化染色法检测70例原发性卵巢上皮性癌组织中COX-2的表达,分析其与卵巢上皮性癌临床病理因素、治疗反应、生存时间之间的相关性。结果卵巢上皮性癌组织中COX-2表达阳性率为60％。其中,治疗后CA125下降不满意患者的阳性率(76％)显著高于下降满意者(51％,P=0.042);复发患者(67％)高于未复发者(46%),但两者比较,差异无显著性(P=0.062)。单因素分析显示,COX-2表达阳性患者的中位数生存时间(28个月)明显短于阴性者(>38个月,P=0.029)。多因素分析显示,病理类型、手术病理分期、COX-2表达情况是影响患者预后的独立因素(P值分别为0.038、0.012、0.036)。结论 COX-2表达与卵巢上皮性癌患者的治疗反应相关,是影响患者预后的独立危险因素。

Objective To investigate the relationship between expression of cyclooxygenase 2 (COX-2) and chemotherapy response and prognosis of patients with ovarian carcinoma. Methods The expression of COX-2 was detected by immunohistochemistry in ovarian carcinoma tissues. Correlations between COX-2 and clinicopatho-logical markers, therapeutic effect and prognosis of the patients with ovarian carcinoma were analyzed by x2 test, Kplan-Meire and COX model. Results COX-2 positive rate of 70 ovarian carcinomas was 60% . Expression of COX-2 was correlated with lymph nodes metastasis only ( P = 0.001). There was no correlation between COX-2 and pathohistological types, clinical stage, pathohistological grade, age at diagnosis (P = 0. 397, 0. 094, 0. 275, 0. 394). In patients whose serum CA125 level did not drop to normal after two courses of chemotherapy, the COX-2 positive rate (76% ) was significantly higher than in those whose serum CA125 level decreased obviously (51% , P = 0. 042). The positive rate was also higher in patients with recurrent diseases (67% ) than in those without recurrence (46% , P = 0.062) . In univariate survival analysis, the expression of COX-2 was associated with a significantly reduced median survival time ( P = 0. 029 ). In multivariate survival analysis, COX-2 was an independent prognostic factor for poor survival ( P = 0. 036). Conclusions COX-2 expression is correlated with poor chemotherapy response and prognostic outcome. It is an independent prognostic factor of ovarian carcinoma.