环氧合酶-2在预测鼻咽癌放疗效应中的价值

The value of cyclooxygenase-2 to predict the effect of radiotherapy in nasopharyngeal carcinoma

目的:探讨鼻咽癌(NPC)肿瘤组织中环氧合酶-2(COX-2)的表达与NPC放疗效应的关系,评估COX-2在预测NPC患者放疗效应中的价值,为制订个性化治疗方案提供理论依据,提高患者的生存率和生存质量。方法:应用免疫组织化学法检测30例放射敏感和30例放射抵抗的鼻咽低分化鳞状细胞癌患者在接受放疗前的肿瘤组织中COX-2蛋白的表达情况,分析COX-2的表达与放疗效应的关系。结果:COX-2在NPC中总的阳性表达率为61.67%。在30例放射抵抗的NPC组织中,COX-2表达阳性26例(86.67%),在30例放射敏感的NPC组织中,COX-2表达阳性11例(36.67%),2组比较,差异有统计学意义(P<0.01),2组间COX-2阳性表达强度差异亦有统计学意义(P<0.05)。根据COX-2阳性表达预测NPC患者放疗抵抗,敏感性86.67%,特异性63.33%,准确率75.00%,阳性预测值70.27%,阴性预测值82.61%,假阳性率36.67%,假阴性率13.33%。结论:COX-2可作为预测NPC患者放疗效应的一个指标,可根据治疗前NPC肿瘤组织中COX-2的表达情况选择相对合理的治疗方案。

Objective： To investigate the relation between the expression of COX-2 protein and the effect of radiotherapy, estimate the value of COX-2 in predicting the effect of radiotherapy in patients with nasopharyngeal carcinoma,provide theoretical basement for establishing characteristic project of treatment and raising curative effect and life quantity. Method： The expression of COX-2 protein was examined in 30 radiosensitive and 30 radioresistant poorly differentiated NPC by immunohistochemical staining （SP method） before radiotherapy. The relation between the expression of COX-2 and the effect of radiotherapy was analyzed. Result： The positive rate of COX-2 protein expression was 61.67 % in NPC tissues, there was statistical difference（ P 〈0.01） of the positive rate between the 86.67 % of 30 radioresistant and 36.67 % of radiosensitive NPC tissues. The intensity of COX-2 protein expressions showed statistical difference（ P 〈0.05）,too. Based on the expression of COX-2, the effect of radiotherapy, sensitivity, specificity, accuracy, positive predictive value, negative predictive value, false positive and false negative were predicted as follows： 86.67%, 63.33% ,75.00%, 70.27% ,82.61% ,36.67% and 13.33%, respectively. Conclusion：COX-2 expression may serve as a marker in predicting the response to radiotherapy in NPC. According to the expression of COX-2, the sound treatment scheme can be selected.