COX-2、VEGF-C蛋白在胃癌及癌前病变组织中的表达及意义

Expression and significance of COX-2 and VEGF-C protein in gastric cancer and precancerous lesions

目的探讨环氧合酶-2(COX-2)、血管内皮生长因子C(VEGF-C)蛋白在胃癌及癌前病变组织中的表达及意义。方法回顾性选取2014年3月至2017年3月保存的胃癌标本62例(胃癌组),选取癌旁组织(距癌边缘>5cm)作为对照组,同时选取胃癌前病变标本50例(癌前病变组)。采用免疫组化染色检测两组COX-2、VEGF-C蛋白表达,分析胃癌COX-2、VEGF-C蛋白表达与临床病理特征关系,两者表达与预后的关系等。结果胃癌组COX-2蛋白和VEGF-C蛋白阳性表达率分别为63.08%和61.29%,明显高于癌前病变组和对照组(P<0.05);癌前病变组COX-2蛋白和VEGF-C蛋白阳性表达率分别为36.00%和28.00%,明显高于对照组(P<0.05);TNM分期Ⅰ~Ⅱ期、高分化和无淋巴结转移患者COX-2蛋白阳性表达率分别为58.33%、50.00%和33.33%,明显低于TNM分期Ⅲ~Ⅳ期、中低分化和有淋巴结转移患者(P<0.05);TNM分期Ⅰ~Ⅱ期和无淋巴结转移患者VEGF-C蛋白阳性表达率分别为54.17%和29.63%,明显低于TNM分期Ⅲ~Ⅳ期和有淋巴结转移患者(P<0.05);COX-2蛋白表达与VEGF-C蛋白表达呈正相关(rs=0.411,P<0.05);COX-2(+)VEGF-C(+)组和COX-2(+)组中位总生存时间分别为22个月和21个月,明显低于VEGF-C(+)组和COX-2(-)VEGF-C(-)组(P<0.05)。结论 COX-2、VEGF-C蛋白在胃癌及癌前病变中有重要作用,COX-2、VEGF-C与胃癌淋巴结转移、临床分期以及分化程度有关,COX-2还与患者预后有一定关系。

Objective To investigate the expression and significance of cyclooxygenase-2（COX-2） and vascular endothelial growth factor C（ VEGF-C） protein in gastric cancer and precancerous lesions. Methods From March 2014 to March 2017,62 cases of gastric cancer in our hospital（gastric cancer group） were selected,and the adjacent tissues（from the edge of cancer 5 cm） were selected as control group,50 cases of gastric precancerous lesions were selected,the expression of COX-2 and VEGF-C protein were detected by immunohistochemical staining. Analysis of the relationship between the expression of COX-2 and VEGF-C protein and clinicopathological features in gastric carcinoma,and the relationship between the expression and prognosis of gastric carcinoma. Results The positive expression rate of COX-2 protein and VEGF-C protein in gastric cancer group were 63. 08% and 61. 29% respectively,which were significantly higher than that in the precancerous lesion group and the control group（ P〈0. 05）. The positive expression rate of COX-2 protein and VEGF-C protein in precancerous lesion group were 36% and 28% respectively,which was significantly higher than that in the control group（ P〈0. 05）. The positive rate of COX-2 protein expression in stage TNM stage I ~ II,high differentiation and non lymph node metastasis were 58. 33%,50% and 33. 33%,respectively,which were significantly lower than those in TNM stage III ~ IV,low differentiation and lymph node metastasis（ P〈0. 05）. The positive rate of VEGF-C protein in TNM stage I ~ II and non lymph node metastasis were 54. 17% and 29. 63%,respectively,which were significantly lower than those in TNM stage III ~ IV and lymph node metastasis（ P〈0. 05）. The expression of COX-2 protein was positively correlated with the expression of VEGF-C protein（ rs = 0. 411,P〈0. 05）. The median overall survival time of COX-2（ ＋） VEGF-C（ ＋） group and COX-2（ ＋） group were 22 months and 21 months,respectively,which were significantly lower than that of VEGF-C（ ＋） group and COX-2（-）VEGF-C（-） group（ P〈0. 05）. Conclusion COX-2 and VEGF-C proteins play an important role in gastric cancer and precancerous lesions. COX-2 and VEGF-C are related to lymph node metastasis,clinical stage and differentiation degree,there is a certain relationship between COX-2 and prognosis of patients.