运用组织芯片技术检测COX-2在结直肠癌中的表达及其临床意义

目的 探讨结直肠癌组织中COX-2的表达及其与各临床病理因素的关系，评价COX-2在结直肠癌预后判断中的价值。方法 应用组织芯片技术结合免疫组织化学SABC法，检测126例早中期结直肠癌组织中COX-2的表达情况，回顾性分析COX-2与各临床病理因素及预后之间的关系。结果 根据免疫组化染色强度，所有病例被分为COX-2高表达组和低表达组，其中高表达组有32例（25．4％），低表达组有94例（74．6％）。COX-2在结直肠癌中表达情况与年龄、性别、肿瘤大小、肿瘤部位、组织学类型、浸润深度、淋巴是否转移、Dukes分期均无相关。然而，高表达的COX-2与肿瘤复发、特别是血行转移显著相关（P〈0．05）。两组之间生存率具有显著差异（P=0．0067），COX-2高表达组术后五年生存率显著低于低表达组。多因素回归模型分析结果显示．在潜在的预后因素中（年龄、性别、肿瘤大小、肿瘤部位、组织学类型、淋巴是否转移、Dukes分期、COX-2表达），COX-2表达和Dukes分期可作为是结直肠癌根治术后独立预后因素，COX-2的检测可作为结直肠癌患者预后判断的一个有价值的指标。结论 高表达的COX-2与肿瘤复发、特别是血行转移显著相关，COX-2的检测町作为结直肠癌患者琐后判断的一个有价值的指标：应用组织芯片高效检测临床组织样本具有快速、方便、经济、准确的优点。

Expression of COX-2 protein in colorectal carcinoma and the clinical implication

OBJECTIVE: To investigate the relationship between COX-2 expression and the clinicopathological factors in colorectal carcinoma and assess the prognostic value of COX-2 detection. METHODS: Tissue microarray and immunohistochemistry by SABC method was employed for detecting COX-2 expression in 126 patients with advanced colorectal cancer, and the relationship of COX-2 expression with the clinicopathological features and prognosis of the patients was retrospectively analyzed. RESULTS: The patients were divided into two groups of low and high COX-2 groups according to the grade and extent of COX-2 expression. High COX-2 expression was detected in 32 (25.4%) cases, and low expression in 94 (74.6%) cases. No significant correlation was noted between COX-2 expression and the patients' age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis and Dukes' classification, but high COX-2 expression was strongly correlated with tumor recurrence and especially with blood-borne metastasis (P<0.05). The survival rate without tumor recurrence for high- and low-COX-2 groups was assessed by the Kaplan-Meier method and compared by log-rank test, which revealed significant difference between the two groups (P=0.0067). Multivariate analysis for all patients suggested that among the 8 prognostic factors (age, sex, tumor size, tumor location, histological type, lymphatic-node metastasis, Dukes' stage, and COX-2 expression), Dukes' stage and COX-2 expression was the independent significant factor related to disease-free survival. CONCLUSION: The expression of COX-2 is strongly correlated with recurrence of colorectal cancer, especially with blood-borne metastasis. COX-2 is an independent factor for prognostic evaluation of the patients, and tissue microarray allows rapid, convenient, economic and accurate COX-2 detection for large-scale application.