家族性腺瘤性息肉病中COX-2的表达分析

Analysis of cyclooxygenase-2 expression in patients with familial adenomatous polyposis

目的:分析环氧化酶2(COX-2)在家族性腺瘤性息肉病(FAP)中的表达,探讨COX-2在腺瘤形成以及癌变过程中的可能作用。方法:收集我科2001年1月至2003年6月10例FAP患者手术切除标本,分别取≤0.5 cm、≥1 cm的腺瘤性息肉以及癌变腺瘤组织,采用EnVision免疫组化方法观察COX-2在这些病灶中的表达。结果:COX-2主要在上皮细胞内表达,在部分间质细胞中也表达。COX-2在≤0.5 cm腺瘤上皮细胞中的表达强于正常上皮,但相差并不显著;在≥1.0 cm腺瘤中表达显著强于正常上皮(P<0.01);在不同大小腺瘤之间的表达差异显著,≥1.0 cm腺瘤中表达强于≤0.5 cm腺瘤(P<0.01);癌变腺瘤中的COX-2表达显著高于正常上皮(P<0.01);癌变腺瘤中表达强于≥1.0 cm的腺瘤组织,但相差并不显著。结论:COX-2可能是FAP发展中的重要促进因子,参与了腺瘤早期形成以及癌变过程;选择性抑制COX-2是预防治疗FAP的有效靶点。

Objective：To analyze the expression of cyclooxygenase-2（COX-2） in patients with familial adenomatous polyposis and to discuss the possible role of COX-2 in adenoma formation and cancerization. Methods： The adenoma specimens were obtained from 10 FAP patients （2001-2003）. Different sizes （≤0.5 cm and ≥1 cm） of adenomas and cancerous adenomas were subjected to Envision immunohistochemistry for analysis of COX2 protein expression. Results： COX2 was mainly detected in epithelial cells, with some in interstitial cells. When ≤0.5 cm, COX-2 expression in adenomatous epithelial cells was stronger than in normal epithelial cells （P〉 0.05）; the same was true when ≥1.0 cm, but with statistical significance （P〈0.01）. The expression of COX-2 in different sizes of adenomas was significantly different（P〈0.01）, with that in ≥1.0 cm adenomas stronger than that in ≤0.5 cm adenomas. Expression of COX-2 in cancerous adenoma was stronger than that in normal epithelial cells （P〈0.01） and epithelial cells of ≥1.0 cm adenomas （P〉0.05）. Conclusion： COX-2 may be a stimulative factor in the progression of FAP and may participate in adenoma formation and cancerization. Selective inhibition of COX2 may be an effective strategy for preventing FAP.