COX-2对宫颈鳞癌预后影响的临床研究

Clinical study on effect of COX-2 in prognosis of cervical squamous cell carcinoma

目的研究环氧合酶-2(Cyclooxygenase-2,COX-2)在宫颈鳞状细胞癌中的表达及对预后的影响。方法选择2008年6月—2009年10月在邯郸市第一医院和中心医院住院治疗的原发宫颈鳞癌患者77例,采用免疫组化S-P法,检测COX-2在宫颈鳞癌中的表达情况及其与预后的关系。结果 COX-2在77例宫颈鳞癌中的阳性表达率为68.8%(53/77),单因素分析显示COX-2的表达与宫颈癌的生存率无关(P>0.05),多因素分析发现:COX-2与组织学分级、临床分期、淋巴结转移、宫旁或脉管浸润及肌层浸润深度为宫颈鳞癌预后的危险因素(P<0.05)。患者的5年生存率为74.03%,生存时间最短8.6个月,最长62个月。结论 COX-2为宫颈鳞癌的独立预后因素,对判断预后及指导治疗具有重要的临床价值。

Objective To study the expression of COX- 2 in cervical malignant squamous epithelium cancer and theeffect of COX-2 on prognosis of patients with cervical squamous cell carcinoma. Methods The 77 primary cervical cancerpatients in Handan Municipal First Hospital and Handan Municipal Central Hospital from June 2008 to October 2009 wereselected. The expression of COX- 2 in 77 paraffin section was identified by immunohistochemically S- P method, and therelationship between the expression of COX-2 and the prognosis of cervical squamous cell carcinoma was studied. Results The positive expression rate of COX-2 was 68.8%（53/77）in 77 patients with cervical squamous cell carcinoma. The log-ranktest was used and the result showed COX- 2 were uncorrelated with survival rate of cervical cancer patients（χ2=3.321,P〈0.05）. The Cox Regression analysis revealed that COX-2,histological grade,clinical stage,lymph node metastasis,parametrialinfiltration or lymph-vascular space invasion and infiltrative depth of muscle were risk factors affecting the survival of patientswith cervical squamous cell carcinoma（P〈0.05）. 5-year survival rate of the patients was 74.03%, with the shortest survivaltime of 8.6 months and longest of 62 months. Conclusion COX-2 is the independent factor for prognosis of patients withcervical squamous cell carcinoma,which might play an important role in prognosis and directing clinical therapy of patientswith cervical squamous cell carcinoma.