环氧化酶2与翼状胬肉患者角膜缘干细胞移植术后复发的相关性

Relationship between cyclooxygenase-2 and recurrence after corneal limbal stem cell transplantation in patients with pterygium

目的探究环氧化酶2(Cox-2)与翼状胬肉患者角膜缘干细胞移植术后复发的相关性。方法回顾性选取于2017年6月至2019年6月安徽医科大学第一附属医院东区住院的74例翼状胬肉患者作为研究组(n=74),取同期患有白内障或青光眼且无翼状胬肉的患者66例作为对照组(n=66)。收集研究组患者术后切除的翼状胬肉组织,同时收集对照组患者术后切取的球结膜组织标本,进行苏木精-伊红染色法和免疫组织化学染色,最后进行常规病理检查及免疫组织化学检查。将两组研究对象组织标本中Cox-2的表达水平及阳性率进行比较,检测Cox-2阳性组与阴性组血管内皮生长因子(VEGF)、血小板衍生生长因子(PDGF)水平,记录患者术后复发情况,并将Cox-2表达与患者的复发情况进行Spearman相关性分析。结果研究组Cox-2的表达水平为(2.78±0.83)ng/mL,明显高于对照组[(0.52±0.15)ng/mL],研究组总阳性率为85.14%,明显高于对照组(13.63%),差异均有统计学意义(P<0.05)。在Cox-2阳性的组织标本中,VEGF、PDGF的阳性率为87.30%、90.48%,明显高于Cox-2表达阴性的组织标本(18.18%、9.09%),差异均有统计学意义(P<0.05)。Cox-2阳性表达患者在6个月、1年及2年内出现复发情况的概率均高于对照组,但差异无统计学意义(P>0.05)。经Spearman相关性分析可知,Cox-2表达与VEGF、PDGF表达水平及翼状胬肉患者复发均呈正相关性(r=0.52、0.54、0.47,P<0.05),Cox-2表达水平越高,患者VEGF和PDGF的表达水平更高,且术后复发的风险也越高。结论COX-2在翼状胬肉组织中的表达水平显著高于正常角膜组织,患者进行角膜缘干细胞移植术后,COX-2的表达水平越高则患者组织中VEGF、PDGF的表达水平越高,且术后复发率也越高。

Objective To investigate the relationship between cyclooxygenase-2(Cox-2)and recurrence after corneal limbal stem cell transplantation in patients with pterygium.Methods A sample of 74 patients with pterygium in the First Affiliated Hospital of Anhui Medical University from June 2017 to June 2019 were retrospectively selected as study group,meantime another 66 cataract or glaucoma patients without pterygium were selected as control group.Postoperatively,hematoxylin-eosin staining and immunohistochemical staining were performed on pterygium tissue from study group and bulbar conjunctiva tissue from control group.Thereafter,routine pathological examination and immunohistochemical examination were performed.The expression level and positive rate of Cox-2 in tissues of two groups were compared.The levels of vascular endothelial growth factor(VEGF)and platelet derived growth factor(PDGF)in Cox-2-positive and-negative groups were tested,and the postoperative recurrence was recorded.Then the correlation of Cox-2 expression with patients'recurrence was discussed using Spearman correlation analysis.Results The expression level of Cox-2 in the study group was(2.78±0.83)ng/mL,which was significantly higher than that in the control group[(0.52±0.15)ng/mL],the total positive rate of Cox-2 in the study group was 85.14%,which was significantly higher than that in the control group(13.63%),the differences were statistically significant(P<0.05).The positive rates of VEGF and PDGF in Cox-2 positive tissue specimens were 87.30%,90.48%,which were significantly higher than those in Cox-2 negative tissue specimens(18.18%,9.09%),the differences were statistically significant(P<0.05).Two-year follow-up results showed the 6-month,1-year and 2-year recurrence rates of Cox-2 positive expression patients were higher than those of Cox-2 negative expression patients,but the difference was not statistically significant(P>0.05).Spearman correlation analysis showed that Cox-2 expression was positively correlated with VEGF and PDGF expression levels and the recurrence of pterygium(r=0.52,0.54,0.47,P<0.05),indicating that patients with higher the expression level of Cox-2 had higher expression levels of VEGF and PDGF and suffered a greater risk of postoperative recurrence.Conclusion Compared with normal corneal tissues,the expression level of Cox-2 is elevated in pterygium tissue,moreover,patients with corneal limbal stem cell transplantation with higher expression level of Cox-2 have higher expression levels of VEGF and PDGF and suffer a greater risk of postoperative recurrence.