环氧化酶2与鼻咽癌颈淋巴结转移的关系

Relationship between cyclooxygenase-2 in nasopharyngeal carcinoma and cervical lymph node metastasis

目的探讨低分化鼻咽癌组织中环氧化酶2（COX-2）表达与鼻咽癌颈淋巴结转移的关系。方法选择以2003年1月至2012年7月在郑州大学第一附属医院确诊的低分化鼻咽癌患者为研究对象，依据患者标本中COX-2表达情况进行分组：COX-2高表达组和COX-2低表达组，采用回顾性分析的方法分析COX-2表达及与鼻咽癌颈淋巴结转移的关系对预后的影响。结果104例患者COX-2染色的总体阳性率为78．8％（82／104），其中伴有颈部淋巴结转移者COX-2染色阳性率显著高于无颈部淋巴结转移组（84．5％与55．0％，x^2=6．765P=0．009）。进一步比较发现，年龄〈45岁和有颈部淋巴结转移的患者COX-2高表达率显著高于年龄≥45岁和无颈淋巴结转移的患者，分别为58．7％与37．7％，x^2=4．439，P=0．035和52．4％与25．0％，x^2=4．861，P=0．027。随访结束时，COX-2高表达组和COX-2低表达组的复发率分别为32．7％（16／49）和14．6％（8／55），差异具有统计学意（x^2=4．786，P=0．029）。与COX-2高表达组比较，COX-2低表达组转移发生率显著降低，为17．7％与28．6％，x^2=4．037P=0．045。进一步多因素Logistic回归分析显示，COX-2高表达是鼻咽癌复发的危险因素[OR=2．039，95％CI（1．042—5．875）]。结论低分化鼻咽癌组织中COX-2表达增加，是影响患者预后的一个危险因素。

Objective To explore the expression of cyclooxygenase-2 （COX-2） in lowly differentiated nasopharyngeal carcinoma and examine its relationship with cervical lymph node metastasis. Methods On the basis of COX expression, a total of 104 patients with lowly differentiated squamous cell carcinoma NPC were divided into 2 groups of COX-2 high-expression and COX-2 low-expression. The influence on prognosis was assessed by retrospective analysis. Results The overall positive rate for COX-2 staining was 78.8% （82/104）. The rate of patients with lymph node metastasis was significantly higher than that in those without （ 84. 5% vs 55.0% , x^2 = 6. 765, P = 0. 009 ） . Further comparison showed that patients with age 〈 45 years and neck lymph node metastasis had higher rate of COX-2 high expression than those with age 〉 45 years and no cervical lymph node metastasis （ 58.7% vs 37. 7%, X2 = 4. 439, P = 0. 035 ; 52.4% vs 25.0%, x^2 = 4. 861, P = 0. 027 ）. At the end of follow-up, the recurrence rate with inter-group statistical differences （ x^2 = 4. 786, P = 0. 029） was 32. 7% （ 16/49 ） and 14. 6% （ 8/55 ） respectively. Meanwhile, as compared with COX-2 high-expression group, the transferring rate in COX-2 low-expression group significantly decreased （ 17.7% vs 28.6%, x^2 = 4. 037, P = 0. 045 ） . Multiple logistic regression analysis showed that COX-2 high expression was a risk factor of nasopharyngeal carcinoma recurrence [ OR = 2. 039, 95% CI （ 1. 042 - 5. 875 ） ]. Conclusion COX-2 expression is up-regulated in lowly differentiated nasopharyngeal carcinoma tissues. And it may be risk factor influencing the prognosis of NPC.