COX-2、EGFR和E-cad在胃癌预后评估中的意义

Significance of COX-2,EGFR and E-cad in evaluation of prognosis of gastric cancer

目的探讨环氧酶-2(COX-2)、表皮生长因子受体(EGFR)与E-钙粘蛋白(E-cad)在胃癌组织中的表达及其在胃癌预后评估中的意义。方法采用免疫组化染色方法,检测100例胃癌组织和100例对应癌旁组织中COX-2、EGFR与E-cad蛋白的表达情况,分析其与临床病理参数之间的关系,分析三者表达与患者生存率的关系。结果在胃癌组织中COX-2、EGFR蛋白阳性表达率显著高于癌旁组织(P均<0. 01),E-cad蛋白阳性表达率显著低于癌旁组织(P <0. 01)。COX-2、EGFR及E-cad的阳性表达与肿瘤浸润深度、分化程度、淋巴结转移及TNM分期有关(P均<0. 01)。经Pearson相关性分析表明,胃癌组织中E-cad与COX-2、EGFR的表达分别呈负相关(r=-0. 423,P=0. 032; r=-0. 567,P=0. 025); COX-2与EGFR的表达之间无相关性(r=0. 232,P=0. 711)。KaplanMeier生存分析5年总生存率比较,COX-2阳性表达者(10. 2%)低于阴性表达者(39. 4%)(HR=2. 362,95%CI:1. 207～4. 265,P <0. 05); EFGR阳性表达者(8. 2%)低于阴性表达者(37. 7%)(HR=2. 391,95%CI:1. 213～4. 712,P <0. 05); E-cad阳性表达者(33. 3%)高于阴性表达者(7. 8%)(HR=0. 437,95%CI:0. 221～0. 872,P <0. 05)。结论 COX-2、EGFR在胃癌组织中表达升高,E-cad表达降低,可作为胃癌预后评估的可靠预测指标。

Objective To investigate the expressions of cyclooxygenase-2（COX-2）,epidermal growth factor receptor（EGFR） and E-cadherin（E-cad） in gastric cancer tissues and the significance in the evaluation of prognosis of gastric cancer. Methods The immunohistochemistry method was used to detect the expression levels of COX-2,EGFR and E-cad in gastric cancer tissues and corresponding paracancerous tissues from 100 patients with gastric cancer and analyze the relationship between the expression levels of three indexes and clinicopathological parameters,survival rate of the patients.Results The positive expression rates of COX-2 and EGFR protein in gastric cancer tissues were significantly higher than those in paracancerous tissue（all P〈0.01）,and the positive expression rate of E-cad protein in gastric cancer tissue was significantly lower than that in paracancerous tissue（P〈0.01）. The positive expressions of COX-2,EGFR and E-cad were associated with the depth of tumor invasion,the degree of tumor differentiation,lymph node metastasis and TNM clinical stages（all P〈0.01）. Pearson correlation analysis showed that E-cad expression was negatively correlated with COX-2 and EGFR expressions（r =-0. 423,P = 0. 032; r =-0. 567,P = 0. 025）. There was no correlation between COX-2 and EGFR expressions（r = 0. 232,P = 0. 711）. Kaplan-Meier survival analysis showed that the 5-year survival rate in patients with COX-2 positive expression was significantly lower than that in patients with COX-2 negative expression（10. 2% vs39. 4%,HR = 2. 362,95% CI： 1. 207-4. 65,P〈0.05）. The 5-year survival rate in patients with EGFR positive expression was significantly lower than that in patients with EGFR negative expression（8. 2% vs 37. 7%,HR = 2. 391,95% CI： 1. 213-4. 712,P〈0.05）. The 5-year survival rate in patients with E-cad positive expression was significantly higher than that in patients with E-cad negative expression（33. 3% vs 7. 8%,HR = 0. 437,95% CI： 0. 221-0. 872,P〈0.05）. Conclusion The expression levels of COX-2 and EGFR in gastric cancer tissues rise,while the expression level of E-cad reduces,so they can served as reliable predictive indexes for evaluating prognosis of gastric cancer.