大肠癌组织COX-2和Ki-67及MVD表达与肝转移相关性的研究

Effect of expression of COX-2, Ki-67 and MVD on hepatic metastasis of colorectal cancer

目的:研究COX-2、Ki-67和微血管密度(MVD)在大肠癌组织中的表达及其相互关系,探讨影响大肠癌肝转移的因素。方法:回顾性分析56例大肠癌肝转移病例的临床病理特征,并取56例无肝转移病例作对照。用免疫组织化学方法检测大肠癌标本中COX-2、Ki-67的表达和MVD,分析三者之间及其与临床病理因素的相关性。用单因素和多因素分析研究影响大肠癌肝转移的相关因素。结果:本组大肠癌COX-2蛋白阳性率为91.1%,Ki-67LI为(44.1±15.0)%,MVD平均为(42.1±9.5)/高倍视野。大肠癌组织中COX-2、Ki-67LI和MVD相互之间具有极强的相关性,并且三者都与肿瘤的Duke分期和肝转移密切相关。多因素Logistic回归分析发现,Duke分期、浸润深度、腹水、COX-2表达和MVD是大肠癌肝转移最重要的5个影响因素。结论:Duke分期、浸润深度、腹水、COX-2表达和MVD是大肠癌肝转移的5个独立影响因素,常规检测临床和生化指标有助于早期发现大肠癌肝转移。

OBJECTIVE： To explore the expressions of COX-2, Ki-67 and microvessel density （MVD） in colorectal cancer tissues and their relationship, and investigate the risk parameters of affecting hepatic metastasis of colorectal cancer. METHODS： Fifty-six patients who had suffered from colorectal cancer with synchronous hepatic metastasis were enrolled in this study and 16 clinlcopathological parameters of primary tumors were collected retrospectively for statistical analysis and compared with 56 cases without synchronous hepatic metastasis. The expressions of COX-2, Ki-67 and MVD in colorectal cancer tissues were detected by the immunohistochemlcal method. The dependablities anong them and clinicopathologlcal parameters of primer colorectal cancer were analyzed. The risk factors correlated with hepatic metastasis were studied by the univariate and multivariate analysis. RESULTS： COX-2 positive, Ki-67 label index （LI） and MVD in colorectal cancer were 91.1%, （44.1±15.0）% and 42.1±9.5/highpower field, respectivly. Expression of COX-2, Ki-67 label index （LI） and MVD in colorectal cancer were correlated, and they were all correlated with Duke stages and hepatic metastasis of colorectal cancer. The multivariate Logistic regression analysis showed COX-2, MVD, depth of infiltrating Duke stages and ascites were high risk factors correlated with hepatic metastasis of gastric cancer. CONCLUSION： COX-2, MVD, depth of infiltrating, Duke stages and ascites are the high risk factors of hepatic metastasis of colorectal cancer independently, and the detection of them can predict hepatic metastasis of colorectal cancer.