环氧化酶2及核因子κB在胃黏膜相关淋巴瘤组织中的表达及其临床意义

Protein expression and clinical significance of cyciooxygenase 2 and nuclear factor kappa B in gastric mucosa-associated lymphoid tissue iymphoma

目的探讨环氧化酶2（COX-2）及核因子κB（NF—κB）蛋白在胃黏膜相关（MALT）淋巴瘤组织中的表达及其临床意义。方法采用Envision二步法检测47例MALT淋巴瘤组织中COX-2和NF—κB蛋白的表达，并对其与幽门螺杆菌（Hp）感染、肿瘤大小和临床病理分期及浸润深度等指标的相关性进行分析。结果本组MALT淋巴瘤组织中COX-2和NF—κB蛋白阳性表达率分别为48．9％（23／47）和36．2％（17／47），两者表达呈正相关关系（r=0．326，P〈0．05）；COX-2表达与伽感染、肿瘤临床病理分期和浸润深度及肿瘤大小明显相关（P〈0．05）。生存分析显示，COX-2阳性组病例的存活时间（59．9个月）短于阴性组（77．8个月），但两组间差异无统计学意义（P〉0．05）；NF—κB阳性组病例的存活时间（26个月）显著短于阴性组（123．2个月），差异具有统计学意义（P〈0．05）。肿瘤临床病理分期是胃MALT淋巴瘤预后的独立影响因素（风险度为3．041，回归系数为1．112，Wald统计量为13．985，P〈0．01），且与预后呈负相关；而COX-2和NF—κB均不是影响预后的独立因素。结论COX-2表达上调和NF-κB激活与胃MALT淋巴瘤伽感染有关，且表达水平与肿瘤进展及预后密切相关。

Objective To investigate the protein expression of cyclooxygenase 2 （COX-2） and nuclear factor kappa B （NF-κB） in gastric mucosa-associated lymphoid tissue （MALT） lymphoma and its clinical significance. Methods Protein expression of COX-2 and NF-κB in gastric MALT lymphoma were examined by immunohistochemistry of Envision two-step method. The correlations of COX-2 and NF-κB expression with Helicobacter pylori （Hp） infection, clinical stage, depth of tumor invasion, tumor size, recurrent rate and treatment were analyzed by univariate, multivariate and Pearson analysis. Results The positive expression of COX-2 and NF-κB in gastric MALT lymphoma were 48.9%（23/47） and 36.2% （17/47） respectively, and a positive correlation was found between these two factors （r=0.326,P〈0.05）. Moreover, COX-2 expression was positively correlated with Hp infection,clinical stage, depth of invasion and tumor size （P〈0.05）. Univariate analysis showed that the overall survival of gastric MALT lymphoma patients with positive COX-2 protein （59.9 months） was shorter than that of patients with negative COX-2 protein （77.8 months）, but the difference was not significant （P〉0.05）. The survival was significantly shorter in gastric MALT lymphoma patients with positive NF-κB protein （26 months） than that of patients with negative NF-κB protein （123.2 months） （P〈0.05）. Multivariate Cox regression analysis revealed that clinicopathological stage was independent prognostic factor, and associated with short survival. Conclusion Up-regulated expression of COX-2 and activation of NF-κB are associated with Hp infection in gastric MALT lymphoma, and their protein expression is correlated with the development of tumor and prognosis.