环氧化酶-2在放疗后复发喉癌中的表达

Expression of COX-2 protein in recurrent laryngeal cancer after radiatheraphy

目的研究环氧化酶-2与喉癌对放疗抗拒之间的关系,改善喉癌患者的生存率。方法选取122例早期喉癌患者,其中包括了61例放疗敏感组和61例放疗抗拒组。所有患者都单纯行根治性放疗。用免疫组化的方法检测治疗前活检标本中COX-2的表达情况。结果在放疗抗拒组,61例中有41例(67%)肿瘤COX-2阳性。放疗敏感组,61例患者仅25例(41%)COX-2蛋白阳性(P=0.004)。COX-2蛋白表达和肿瘤T分期无明显相关(P=0.08),且和肿瘤的分化程度(P=0.181)及声门上或声门区(P=0.757)无相关性。COX-2表达和放疗抗拒患者喉癌复发时间无相关性(P=0.126)。COX-2用作早期喉癌放疗是否敏感的预测因子准确度为67%。结论 COX-2可作为喉癌对放疗是否敏感的预测因子,联合其他生物标志也或许将提高预测是否放疗敏感的准确性。

Objective To investigate the relationship between COX-2 expression and radioresistance in laryngeal cancer, and Improve the survival rate of patients with laryngeal cancer. Methods The group comprised of 61 radioresistant and 61 radiosensitive patients matched for T stage, laryngeal subsite, gender and smoking history. All patients were treated with only radiotherapy for curative intent. Using immunohistochemical techniques to examine the expression of COX-2 protein in 122 laryngeal biopsies before treatment. Results COX-2 positive expression was detected in 41 of 61 （67%） biopsy samples from patients with radioresistant tumours and 25 of 61 （41%） radiosensitive tumours. Positive expression was significantly associated with radioresistant tumours （P=0.004）. Cox-2 has 67% accuracy in predicting radiotherapy failure. There was no significant association among COX-2 expression and T stage （P=0.08）, degree of tumour differentiation （P=0.181） or laryngeal glottic or supraglottic subsite（P=0.757）. COX-2 expression was also not related to time of recurrence in the radioresistant group （P=0.126）. Conclusion COX-2 may have prognostic value in predicting response to radiotherapy. If combined with other biological marker, the predicted accuracy may increase.