鼻内翻性乳头状瘤中COX-2、p21、Ki-67的表达及HPV感染的临床意义

Significances of COX-2,p21,Ki-67expression and HPV infection in nasal inverted papilloma

目的:探讨鼻内翻性乳头状瘤组织中COX-2、p21、Ki-67的表达及HPV感染的临床意义。方法:应用免疫组织化学二步法检测30例鼻内翻性乳头状瘤(NIP)和20例鼻息肉(NP)及10例正常鼻腔黏膜组织(NM)中COX-2、p21、Ki-67表达情况,并用导流杂交方法检测HPV感染的情况。结果:NIP组、NP组和NM组中COX-2、Ki-67的阳性表达率呈依次降低的趋势;COX-2在3组间比较差异有统计学意义(χ2=30.00,P<0.05);Ki-67在NIP和NM组间比较差异有统计学意义(χ2=8.533,P<0.05)。经Spearman秩相关分析,COX-2与Ki-67的表达呈正相关(r=0.78,P<0.05)。p21在NIP组中未见表达。NIP组HPV病毒检出率为26.67%,均为HPV16型。结论:COX-2、Ki-67和HPV感染与NIP的发生、发展有一定相关性。COX-2介导的炎症反应,可能作为NIP发病的危险因素。Ki-67能较好地反映肿瘤细胞增殖活性,可作为衡量鼻内翻性乳头状瘤的增殖活性的指标。COX-2与Ki-67的表达在NIP的发病中具有协同作用。p21与NIP发病无明显相关。HPV感染与NIP的发病有关,但不能作为NIP发病的主要因素。

Objective：To investigate the significance of expression of COX-2,p21, Ki67 and HPV in nasal in- verted papilloma. Method：Detecting COX-2, p21, Ki-67 in 30 cases of nasal inverted papilloma （NIP）, 20 cases of nasal polyps （NP） and 10 cases of normal nasal mucosa （NM） by two step immunohistochemical method,and HPV virus by flow-through hybridization method. Result：The positive expression rate of COX-2 and Ki-67 in NIP, NP and NM group was decreased in turn, COX-2 had significant difference in the groups（x^2 = 30.00, P〈 0.05）; the positive expression rate of Ki-67 had significant differences between NIP and NM group （3（z = 8. 533, P〈0.05）. The expression of COX-2 in NIP tissues was positively correlate with that of Ki-67 by using Spearman rank correlation analysis （r=0.78, P^0.05）. Expression of p21 were not observed in NIP group. The positive rate of HPV was 26.67% in 30 cases of NIP, all of HPV16 type. Conclusion：COX-2, Ki-67 and HPV infection have certain correlation with the occurrenee of NIP. The occurrence of NIP has relationship with inflammatory re- aetion mediated by COX-2. Ki-67 can well reflect the proliferation activity of tumor cells, and can be used to meas- ure the proliferation rate of nasal inverted papilloma. The COX-2 and Ki-67 have a synergistic role in the patho- genesis of NIP. p21 has no significant relationship with the incidence of NIP. HPV infection is related to the path- ogenesis of NIP, but not as a maior factor in the pathogenesis of NIP.