上皮性卵巢癌组织中环氧化酶-2的表达与化疗耐药的相关性研究

Relationship of cyclooxygenase-2 expression and chemotherapy resistance in epithelial ovarian cancer patients

目的:探讨上皮性卵巢癌组织中环氧化酶-2(cyclooxygenase-2,COX-2)表达与化疗耐药的关系,以及与p53表达的相关性。方法:用免疫组化SP法检测108例上皮性卵巢癌组织和20例正常卵巢组织中COX-2和p53表达。结果:COX-2和p53在上皮性卵巢癌组织中阳性表达率分别为48.1%和59.3%,正常卵巢组织均未见表达,差异有极显著性(P<0.01);COX-2和p53表达呈显著正相关(P<0.01)。COX-2表达与患者病理类型、临床分期、病理分级及年龄无关,与术后残留灶直径有显著相关性(P<0.01)。COX-2和p53阳性表达率,耐药组和非耐药组相比均有显著差别(P<0.01)。多因素分析显示,卵巢癌患者COX-2、p53表达和术后残留灶直径是与化疗耐药密切相关的独立因素。结论:COX-2表达是与化疗耐药相关的独立危险因素。COX-2过表达与抑癌基因p53的突变可能具有相互促进作用,在卵巢癌化疗耐药中起重要作用。

Objective ：To investigate the relationship between expression of cyclooxygenase -2 （COX -2） and chemotherapy resistance of patients with epithelial ovarian cancer, and to study the relationship between COX - 2 and p53 expression. Methods：Immunohistochemical assay （SP method） was used to detect the expressions of COX -2 and p53 in 108 epithelial ovarian cancer tissues and 20 normal ovarian tissues . Results：COX -2 and p53 positive rates of 108 epithelial ovarian cancer tissues were 48.1% and 59.3% , respectively . The expressions of COX -2 and p.53 were higher in the patients with epithelial ovarian cancer than that in the patients with normal ovarian tissues （ P 〈 0.01 ） ; and there was a significant positive correlation between COX - 2 and p53 expression. There was no correlation between COX -2 and pathohistological types, clinical stage, pathohistological grade, age at diagnosis（P 〉 0.05 ） and there was significant correlation between COX - 2 and the diameter of residual tumor（ P 〈 0.01 ）. In the drug resistance group , the expressions of COX - 2 and p53 were significantly higher than that in the drug sensitive group（ P 〈 0.01 ）. According to multivariate analysis, the expressions of COX - 2 and p53 and the diameter of residual tumor were independent factors correlated with drug resistance for the patients with epithelial ovarian cancer. Conclusion：COX- 2 is overexpressed in epithelial ovarian cancer , and COX -2 expression in epithelial ovarian cancer is a risk factor for drug resistance. Inactivation of antioncogene p53 and overexpression of COX - 2 may play an interaction in the mechanism of chemotherapy resistance in ovarian cancer.