环氧化酶-2和基质金属蛋白酶-7在老年胃癌组织中表达及预后意义

Poor prognosis associated with cyclooxygenase-2 and matrix metalloproteinase 7(MMP-7)expression in aged patients with gastric carcinoma

目的 :研究环氧化酶 2 (COX 2 )和基质金属蛋白酶 7(MMP 7)在老年胃癌中表达及预后意义。方法 :采用免疫组化法检测了 87例老年胃癌COX 2、MMP 7表达情况 ,分析它们与胃癌临床病理特征关系及对预后的影响。结果 :COX 2、MMP 7在胃癌的表达明显高于慢性萎缩性胃炎 ,进展期癌的表达又高于早癌 (P <0 .0 1)。COX 2、MMP 7表达呈正相关 (P <0 .0 5 )。COX 2、MMP 7表达与肿瘤大小、淋巴结转移、血管癌栓、TNM分期呈正相关 (P <0 .0 1) ,COX 2、MMP 7表达阳性组的整体生存率明显低于COX 2、MMP 7阴性组 (P <0 .0 1) ,二者共同表达预后更差。多因素分析表明 :淋巴结转移、TNM分期、MMP 7阳性表达是老年胃癌预后独立因素。结论 :COX 2、MMP 7表达呈正相关 ,与胃癌生长、浸润转移关系密切 。

Objective:To investigate the expression of cyclooxygenase-2(COX-2) and MMP-7and their influence on clinicopathological characteristics and the prognosis in aged pctients with gastric carcinoma. Methods:Expression of COX-2 and MMP-7 were examined with immnunohistochemical technique in 87 cases gastric carcinoma specimens.Results:Expression of COX-2 and MMP-7 were significantly higher in gastric carcinoma than that in chronic atrophic gastritis.Cox and MMP-7 levels in advanced carcinoma were higher compared with early carcinoma(P<0.01).A significant correlation was found between COX-2 and MMP-7.The expression of COX-2 and MMP-7 were related to the tumour size,depth,lymph node metastasis,vessel invasion and TNM stage. The survival rate in the patients with Cox-2 or MMP-7 expression was much lower than the rate in those patients without expression of COX-2 and MMP-7.The prognosis of patients with both COX-2 and MMP-7 expression was extremely poor.By multivariate analysis,it demonstrated that MMP-7 expression was an independent prognostic factor after lymph node metastasis and TNM stage.Conclusion:Overexpression of Cox-2 and MMP-7 in gastric carcinoma enhance the possibility of invasion and metastasis and implicate a poor prognosis.