COX-2、VEGF在胃癌中的表达及其预后意义

Expression of cyclooxygenase-2,vascular endothelial growth factor and their prognostic significance in gastric carcinoma

目的 :研究COX 2、VEGF表达对胃癌的预后意义。方法 :收集我院 1990～ 1999年早、中期胃癌 2 81例 ,对有完整存档蜡块资料的 2 32例进行免疫组织化学染色。检测COX 2、VEGF及MVD在胃癌组织中的表达 ,并分析其预后意义。结果 :胃癌组织中COX 2、VEGF阳性表达的MVD值均显著高于COX 2、VEGF阴性表达者(P <0 0 1) ;COX 2、VEGF阳性表达及MVD值与胃癌淋巴结转移、血管浸润均密切相关 (P <0 0 1) ;COX 2、VEGF阳性表达者五年生存率明显低于阴性者 (P <0 0 1)。多因素分析显示 ,VEGF表达、淋巴结转移、COX 2表达、浸润深度、血管浸润均为胃癌独立的预后因素。结论 :COX 2、VEGF在胃癌组织呈过度表达状态 ,与胃癌的生长和浸润转移关系密切 ,可以作为反映胃癌生物学行为和判断预后的有效指标。

Purpose:To investigate the relationship between expression of COX-2,VEGF in gastric carcinoma and its prognostic significance.Methods:281 patients with early and middle stage of gastric carcinoma were followed up. Expression of COX-2 and VEGF was examined by immunohistochemistry in 232 archival paraffinembedded tissue specimens.Results:The MVD value was much higher in COX-2(+) group and VEGF(+) group than that in COX-2(-) group and VEGF(-) group ( P <0.01). Expression of COX-2,VEGF and the MVD value were highly correlated with lymph node metastasis and vascular invasion( P <0.01). The 5-year survival rate in the patients with COX-2,VEGF expression was much lower than the rate in those patients without COX-2,VEGF expression ( P <0.01). Multivariate analysis indicated that VEGF expression,lymph node metastasis,COX-2 expression,depth of invasion and vascular invasion were all independent prognostic factors of gastric carcinoma.Conclusions:Overexpression of COX-2 and VEGF in patients with gastric carcinoma can enhance the possibility of invasion and metastasis,impliying a poor prognosis. They may serve as fairly good prognostic factors to indicate biologic behavior and prognosis in gastric carcinoma.