COX-2、Ki-67在肝胆管结石并胆管癌组织中的表达及其与临床病理特征的相关性

Study of COX-2 and Ki-67 Expression in Hepatobiliary Calculus with Cholangiocarcinoma

【目的】探讨COX-2、Ki-67在肝胆管结石并胆管癌组织中的表达及相关性。【方法】选择2006年1月至2016年12月湖南省人民医院肝胆外科收治的行外科手术治疗临床资料完整的患者117例，其中将肝血管瘤或肝外伤切除标本的胆管组织标记为A组（n=18），行肝叶切除肝内结石所在胆管组织标记为B组（n=55），行手术切除肝胆管结石并胆管癌组织标记为c组（n=44）。应用免疫组织化学法检测各组COX-2、Ki-67的表达情况，分析肝胆管结石并胆管癌组织C0x_2、Ki-67的表达特点及其与各项临床病理特征之间的相关性。【结果】c组胆管组织中C0x-2、Ki-67阳性表达率明显高于A组和B组，差异均具有统计学意义（P〈O．05）。不同年龄、性别、病程、肿瘤大小及病理类型的c组患者cox_2、Ki-67阳性表达率比较无统计学差异（P〉O．05），不同组织病理分化程度、是否有淋巴结转移和肝外转移的C组患者C0x_2、Ki-67阳性表达率比较，差异均具有统计学意义（P〈0．05）。COX-2阳性表达的C组胆管组织中Ki-67的阳性表达率为90．32％（28／31），两者的表达呈显著正相关，差异具有统计学意义（P〈0．05）。【结论】肝胆管结石并胆管癌组织COX-2与Ki-67的表达呈显著正相关性，COx_2与Ki-67的高表达在肝胆管结石并胆管癌的发生及进展中发挥一定的作用。

[Objectives] To explore the expression of COX-2 and Ki-67 in patients of hepatobiliary calculus with Cholangiocarcinoma（HCWC）and their clinical significance. Relationship between the expression of COX- 2,Ki-67 and the onset and progress of HCWC was investigated to lay an experimental base for the prevention and treatment of HCWC.[Methods] Eighteen cases （n =18） of normal bile duct tissue from operations of he- mangiomas of liver or liver trauma were used as the control （group A） fifty-five （ n = 55） cases of the bile duct tissue surrounding calculus of intra-hepati were selected as group B, and forty-four （n=44） cases of tumor tissue of HCWC （group C） were randomly sampled and collected between January 2000 to December 2016 in the Department of Hepatobiliary Surgery of Hunan Provincial People＇s Hospital. Immunohistochemis- try was used to detect the expression of COX-2 and Ki-67 as well as their expression in cholangiocarcinoma in correlation with clinicopathological features. The results were statistically analyzed.[Results] In group A, B,C, the positive rates of the expression of COX-2 and Ki-67 were 5.56%, 32.72%, 70.45%, and 0, 27.27%, 79.55%, respectively. The positive rate of the expression of COX-2 and Ki-67 in the carcinoma tissue of HC- WC was significantly higher compared with the control group （ P 〈0.05） the positive rate of COX-2 and Ki- 67 expression in poorly differentiated HCWC cases was higher compared with highly differentiated cases （ P 〈0.05） % the positive rate of COX-2 and Ki-67 in extra-hepatic or lymphatic metastasis HCWC cases was high- er compared with cases without metastasis （ P〈0.05）. There was no significant difference in the expression rate of COX-2 and Ki-67 between the different age groups, sex, duration, tumor size and pathological type of group C （ P 〈0.05）. The positive expression rate Of Ki-67 in COX-2 positive cases of group C was 90.32% （28/31）. Spearman-related analysis showed a strong positive correlation between the expression of COX-2 and Ki-67 in HCWC（ r = 0.413 ,P 〈0.005）.[Conclusions] There is a significantly positive correlation between theexpression of COX-2 and Ki-67 in HCW（＇. The high expression of COX-2 and Ki 67 play a certain role in the occurrence and proress of HCWC：