术前间质化疗对高分化口腔鳞状细胞癌组织中COX-2表达及癌周淋巴管密度的影响

Effects of preoperative interstitial chemotherapy on COX-2 and peritumoral lymphatic vessel density in well-differentiated oral squamous cell carcinoma

目的探讨术前间质化疗对高分化口腔鳞状细胞癌组织中环氧化酶2(COX-2)表达及淋巴管密度(LVD)的影响。方法选择60例高分化口腔鳞状细胞癌患者,其中术前缓释氟尿嘧啶(5-FU)间质化疗者15例(间质化疗组)、术前平阳霉素静脉化疗者15例(静脉化疗组)、未化疗者30例(未化疗组),取肿瘤组织及距肿瘤边缘3 cm组织石蜡标本,免疫组化法检测3组癌组织中COX-2表达及D2-40标记的LVD。结果间质化疗组、静脉化疗组、未化疗组癌组织中COX-2阳性表达率分别为40.0%、66.7%、83.3%,三组间比较,P均<0.05。间质化疗组、静脉化疗组、未化疗组癌周LVD分别为(4.02±0.88)、(8.12±0.79)、(12.22±2.25)支/mm2,三组间比较,P均<0.05。未化疗组癌组织中COX-2表达阳性25例、阴性5例,癌周LVD分别为(12.91±1.66)、(8.75±1.40)支/mm2,二者比较,P<0.01;间质化疗组、静脉化疗组癌组织中COX-2表达阳性16例、阴性14例,癌周LVD分别为(6.66±2.11)、(4.88±2.10)支/mm2,二者比较,P<0.05。未化疗组有淋巴结转移14例、无淋巴结转移16例,癌周LVD分别为(13.79±1.76)、(10.84±1.66)支/mm2,癌组织中COX-2阳性表达率分别为100.0%、68.8%,二者癌周LVD、癌组织中COX-2阳性表达率比较,P均<0.01。结论术前间质化疗能降低高分化口腔鳞状细胞癌组织中COX-2表达,抑制癌周淋巴管形成。

Objective To investigate the effects of preoperative interstitial chemotherapy on the COX-2 expression and lymphatic vessel density( LVD) in well-differentiated oral squamous cell carcinoma( OSCC). Methods Sixty specimens of OSCC were selected,in which 15 specimens were treated by preoperative interstitial chemotherapy with slow-released 5-FU( interstitial chemotherapy group),15 specimens underwent preoperative intravenous chemotherapy with pingyangmycin( intravenous chemotherapy group) and 30 specimens were not treated with chemotherapy( non-chemotherapy group). The carcinomatous tissues and the tissues 3 cm from the carcinoma edge were embedded by paraffin. The expression of COX-2and LVD marked with D2-40 in OSCC was detected by immunohistochemistry. Results The positive expression rates of COX-2 were respectively 40. 0%,66. 6% and 83. 3% in the interstitial chemotherapy group,intravenous chemotherapy group and non-chemotherapy group,and the difference among each group was significant( all P < 0. 05). The average LVD around the carcinoma were respectively( 4. 02 ± 0. 88),( 8. 12 ± 0. 79) and( 12. 22 ± 2. 25) vessels / mm2 in the interstitial chemotherapy group,intravenous chemotherapy group and non-chemotherapy group,and the difference among each group was significant( all P < 0. 05). In the non-chemotherapy group,25 specimens with positive and 5 specimens with negative expression of COX-2,the average LVD around the carcinoma were respectively( 12. 91 ± 1. 66) and( 8. 75 ±1. 40) vessels / mm2,and significant difference was found between them( P < 0. 01). In the interstitial chemotherapy group and intravenous chemotherapy group,16 specimens with positive and 14 specimens with negative expression of COX-2,the average LVD around the carcinoma were respectively( 6. 66 ± 2. 11) and( 4. 88 ± 2. 10) vessels / mm2,and significant difference was found between them( P < 0. 05). In the non-chemotherapy group,14 specimens with lymph node metastasis and 16 specimens without lymph node metastasis,the average LVD around the carcinoma were respectively( 13. 79 ±1. 76),( 10. 84 ± 1. 66) vessels / mm2,the positive expression rates of COX-2 in the carcinomatous tissues were respectively 100. 0% and 68. 8%,and significant difference was found in LVD around the carcinoma and the positive expression rate of COX-2 in the carcinomatous tissues between these two groups( all P < 0. 01). Conclusion Preoperative interstitial chemotherapy could reduce the expression of COX-2 and inhibit the lymphangiogenesis in well-differentiated oral squamous cell carcinoma.