胃癌中COX-2与P-gp表达及其预后的研究

Expression of COX-2 and P-gp and Its Prognosis in Gastric Carcinoma

目的探讨环氧化酶-2(COX-2)与P-糖蛋白(P-gp)在胃癌组织中的表达及其临床意义。方法应用免疫组化SP法检测COX-2和P-gp在60例胃癌组织中的表达情况。结果全组COX-2阳性率为63.3%(38/60),P-gp阳性率为68.3%(41/60)。COX-2的表达与组织分化程度、浸润深度、淋巴结转移和临床TNM分期相关(P<0.05);P-gp的表达与浸润深度、淋巴结转移和临床TNM分期相关(P<0.05)。COX-2和P-gp同时表达、单独表达及不表达时,胃癌的组织分化程度、病变浸润深度(T分期)、淋巴结转移(N分期)和临床分期组间差异有统计学意义(P<0.05)。COX-2和P-gp在胃癌组织中的表达具有相关性(r=0.374,P=0.004)。胃癌患者1、3、5年生存率分别为83.3%、40.0%和30.0%;COX-2阳性组和COX-2阴性组的1、3、5年生存率分别为79.0%、28.9%、15.8%和90.9%、59.1%、54.6%,两组间差异有统计学意义(χ2=7.885,P=0.005)。结论在胃癌组织中COX-2参与了P-gp的表达调控。COX-2的表达可能成为影响胃癌生存的重要预测因子。

Objective To investigate the clinical significance of Cyclooxygenase - 2 （ COX - 2 ） and P - glycoprotein （ P - gp） expressions in Gastric Carcinoma. Methods The expressions of COX - 2 and P - gp of gastric carcinoma tissue were detected by SP immunohistochemical in 60 cases. Results The positive rates of COX - 2 and P - gp were respectively 63.3% （38/60） and 68.3% （41/60） in the whole group, Some significant correlations were observed between the expression of COX - 2 and the clinical factors including degree of differentiation （ Uc = 3 . 582, P = 0. 000）, depth of invasion （ Uc = 3. 084, P = 0. 002）, lymphatic metastasis （ Uc = 2. 570 P = 0. 010） and TNM staging （χ^2 = 7. 552, P = 0. 006 ） ; And there was significant correction between the expression of P - gp and the clinical factors including depth of invasion （ Uc = 2. 448, P = 0. 014）, lymphatic metastasis （ Uc = 2. 547, P = 0. 011 ） and TNM staging （χ^2 = 5. 396, P = 0. 020）. Significant difference was found in degree of differentiation, depth of invasion, lymphatic metastasis and TNM staging when COX - 2 and P - gp repectively in simultaneous expressions, individual expressions and no expressions （ P 〈 0. 05 ）. The expression of COX - 2 was in significant correlation with that of P - gp in gastric carcinoma （ r = 0. 374, P = 0. 004）. The overall survival rates of 1, 3, 5 years were respectively 83.3%, 40. 0% and 30. 0% in the whole group; And in COX - 2 positive group they were respectively 79.0% , 28.9%, 15.8% and in COX -2 negative group were 90. 9%, 59. 1% , 54.6% , and there was significant difference in survival rates between the two groups （χ^2= 7. 885, P = 0. 005）. Conclusion COX - 2 is involved in adjustment of P - gp expression in gastric carcinoma. COX -2 expression may be used as an important survival predictor in gastric carcinoma.