COX-2、PCNA、VEGF和MVD在非小细胞肺癌中的表达及其临床意义

Expression and Pathological Meaning of COX-2,PCNA,VEGF and MVD in Non-small Cell Lung Cancer

目的研究环氧化酶2（cyclooxygenase-2，COX-2）、增殖细胞核抗原（proliferating cell nuclear antigen，PCNA）、血管内皮生长因子（vascular endothelial growth factor，VEGF）和微血管密度（microvessel density，MVD）在非小细胞肺癌（non-smallcell lung cancer，NSCLC）组织中的表达及其与临床病理的关系。方法应用免疫组化SP法检测78例NSCLC组织中COX-2、PCNA、VEGF及CD34表达的微血管密度（MVD）。结果78例NSCLC中，COX-2、PCNA及VEGF的阳性表达率分别为61．5％、89．74％及60．25％，CD34表达的MVD值为（38．5±7．59），COX-2表达与NSCLC组织学、临床分期和淋巴结转移之间存在显著性差异（P〈0．01），TNM（tumor-node-metastasis）分期中Ⅲ～Ⅳ期组，PCNA阳性表达率高于Ⅰ～Ⅱ期，存在显著差异（P〈0．01）；有淋巴结转移组VEGF阳性表达率高于无淋巴结转移组，存在显著差异（P〈0．01）；COX-2阳性表达与VEGF及MVD的表达之间存在显著差异（P〈0．01），COX-2阳性表达强度与PCNA阳性表达强度之间存在显著差异（P＜0．01）。结论COX-2、PCNA、VEGF和MVD在NSCLC发生发展中可能起协同作用，同时检测NSCLC组织中COX-2、PCNA、VEGF及MVD有助于判断患者预后。

Objective To investigate the expression of cyclooxygenase 2 （COX-2）, proliferating cell nuclear antigen （PCNA）, vascular endothelial growth factor （VEGF） and microvessel density （MVD） in non-small cell lung cancer （NSCLC） and their pathological meaning. Methods Immunohistochemical staining （S-P method） for COX-2, PCNA, VEGF and CD34 was performed in 78 cases with NSCLC; the MVD was marked by CD34. Results The positive rate of COX-2, PCNA and VEGF were 61.5%, 89. 74% and 60. 25% respectively. The value of MVD marked with CD34 was （38.50 ± 7. 59）. The expression of COX-2 and PCNA was positively correlated with histological stage, clinical stage and lymph node metastasis of NSCLC （P〈0. 01）. The positive rate of PCNA expression was significantly higher in patients of clinical stage Ⅲ -Ⅳ than in those of stage Ⅰ - Ⅱ （P〈0. 01）. The positive rate of VEGF expression was significantly higher in patients with lymph node metastasis than in those without lymph node metastasis （P〈0. 01）. There was a significant positive correlation between the expression of COX-2 and VEGF. The MVD in positive COX-2 group was significantly higher than that in negative group. The positive grades of COX-2 was closely associated with expression of PCNA protein. Conclusion COX-2, PCNA, VEGF and MVD play cooperate roles in lung cancer development and can be utilized as a useful predictor of prognostic evaluation for NSCLC patients.