COX-2在2型糖尿病合并肺癌组织中的表达及其临床意义

Role and Clinical Significance of COX-2 in Type 2 Diabetes with Lung Cancer

目的探讨环氧合酶-2(COX-2)在2型糖尿病(T2DM)合并肺癌组织中的表达及其临床意义。方法选取44例T2DM合并肺癌患者作为观察组,另选同期单纯肺癌患者44例作为对照组。所有患者均采用以手术为主的方案治疗,获得手术切除的癌组织病理石蜡切片各44份,应用免疫组化法检测COX表达。分析COX-2表达与患者年龄、体质量指数、临床分期、T2DM、淋巴结转移、肿瘤大小的关系;对44例T2DM合并肺癌患者随访2年,记录两组死亡例数,比较存活与死亡患者COX-2表达水平,并绘制ROC曲线分析COX-2在预测T2DM合并肺癌患者预后中的价值。结果观察组COX-2光密度值高于对照组,Ⅰ期、Ⅱ期、Ⅲ期患者COX-2光密度值高于对照组,且同组Ⅲ期患者COX-2光密度值高于Ⅱ期、Ⅰ期,差异有统计学意义(P<0.05);合并T2DM、有淋巴结转移、临床分期高的肺癌患者COX-2表达高于未合并T2DM、无淋巴结转移及临床分期低患者,差异有统计学意义(P<0.05);44例T2DM合并肺癌患者长期随访结果显示,存活26例,死亡18例;存活组COX-2表达水平[(168.25±10.89)]低于死亡组[(198.41±13.36)],差异有统计学意义(P<0.05);绘制ROC曲线分析显示,COX-2预测T2DM合并肺癌患者预后的曲线下面积(AUC)为0.913,预测价值高。结论COX-2在T2DM合并肺癌患者癌组织内呈高表达,并能够良好预测患者预后,且COX-2表达越高则预后越差,值得临床广泛关注。

Objective To investigate the role and clinical significance of cyclooxygenase-2(COX-2)in type 2 diabetes mellitus(T2DM)with lung cancer.Methods 44 patients with T2DM complicated with lung cancerwere selected as the observation group,and 44 patients with simple lung cancer in the same period were selected as the control group.All patients received surgery based treatment.44 pathological paraffin sections of surgically resected cancer tissues were obtained,and the expression of Cox was detected by immunohistochemistry.The expression of COX-2 and COX-2 in different clinical stages were compared between the 2 groups;The relationship between COX-2 expression and age,body mass index,clinical stage,T2DM,lymph node metastasis and tumor size was analyzed;44 patients with T2DM complicated with lung cancer were followed up for 2 years.The number of deaths in the 2 groups was recorded,the expression level of COX-2 between surviving and dead patients was compared,and the ROC curve was drawn to analyze the value of COX-2 in predicting the prognosis of patients with T2DM complicated with lung cancer.Results The optical density of COX-2 in the observation group was higher than that in the control group.The optical density of COX-2 in patients with stage I,II and III was higher than that in the control group,and the optical density of COX-2 in patients with stage III was higher than that in patients with stage II and I(P<0.05);The expression of COX-2 in lung cancer patients with T2DM,lymph node metastasis and high clinical stage was significantly higher than that in patients without T2DM,no lymph node metastasis and low clinical stage(P<0.05);The long-term follow-up results of 44 patients with T2DM complicated with lung cancer showed that 26 cases survived and 18 died;The expression level of COX-2 in the survival group[(168.25±10.89)]was lower than that in the death group[(198.41±13.36)],the difference was statistically significant(P<0.05);The ROC curve analysis showed that the area under the curve(AUC)of COX-2 in predicting the prognosis of T2DM patients with lung cancer was 0.913,which had high predictive value.Conclusion COX-2 is highly expressed in T2DM patients with lung cancer,and can well predict the prognosis of patients.The higher the expression of COX-2,the worse the prognosis,which is worthy of extensive clinical attention.