COX-2和凋亡抑制蛋白在老年胃癌患者原发灶与转移淋巴结中的表达差异

目的:探讨老年胃癌患者原发灶及淋巴结转移灶中环氧合酶2(COX-2)与凋亡抑制蛋白p53,survivin,Bcl-2表达的关系及其意义。方法:用免疫组化染色法检测33例伴淋巴结转移的老年胃癌患者(≥60岁)手术标本中COX-2,p53,survivin和Bcl-2的表达情况,同法检测32例对照组(<60岁)胃癌原发灶、转移灶中上述4种蛋白的表达,比较两组之间、淋巴结转移灶与原发灶之间的表达差异,并进行相关分析。结果:老年组转移灶中Bcl-2的表达高于原发灶(P<0.05),COX-2,p53和survivin表达在两种病灶组织间无统计学差异(均P>0.05),p53及Bcl-2表达在原发灶、转移灶间存在正相关(r分别为0.5470及0.4969,均P<0.01)。老年患者原发灶中COX-2与survivin,COX-2与Bcl-2之间呈正相关(r=0.5053;r=0.5741,均P<0.01),转移灶中survivin与Bcl-2表达呈负相关(r=-0.5414,P<0.01)。老年组原发灶COX-2,survivin和Bcl-2表达明显高于对照组(均P<0.05),而转移灶仅COX-2的表达高于对照组(P<0.05)。结论:大于60岁老年胃癌患者,原发灶与淋巴结转移灶的COX-2的表达与60岁以下的胃癌患者存在差异,这可能导致老年患者凋亡抑制途径与其他年龄患者不同。

Differential expression of cyclooxygenase-2 and inhibitor of apoptosis proteins in primary tumor and metastatic lymph nodes of elderly gastric cancer patients

Objective: To investigate the relationship between the expression of cyclooxygenase-2(COX-2) and inhibitor of apoptosis proteins(p53,survivin and Bcl-2) in the primary tumor and lymph node metastases(LNMs) of gastric cancer of elderly patients.Methods: The expressions of COX-2,p53,survivin and Bcl-2 in the surgical specimens from 33 elderly patients(≥60 years) with gastric cancer and lymph node metastases were detected by immunohistochemical staining,and the expressions of the above 4 proteins in the primary lesion and involved lymph nodes from 32 patients(<60 years) were determined by the same approach to serve as a control.The expression differences between the two groups and between the primary lesion and metastases were compared,and the correlations among them were also analyzed.Results: Of the elderly patients,the Bcl-2 expression was significantly higher in the metastases than that in the tissues of the primary tumor(P<0.05),no significant differences were noted in the expressions of COX-2,p53 and survivin between primary tumor and metastases(all P>0.05),and there were positive correlations between the primary tumor and metastases in the expressions of p53 and Bcl-2(r=0.5470 and 0.4969,both P<0.01).In the primary tumor of elderly patients,there were positive correlations between COX-2 and survivin,and between COX-2 and Bcl-2 as well(r=0.5053 and 0.5741,both P<0.01),while a negative correlation was found between survivin and Bcl-2 in metastases of elderly patients(r=–0.5414,P<0.05).The expressions of p53,survivin and Bcl-2 in the primary tumor of elderly patients were significantly higher than those of the control patients(all P<0.05),while only COX-2 expression was higher than that of control group in the metastases.Conclusion: The COX-2 expression in the primary tumor and lymph node metastases of the patients older than 60 years is different from that of the patients below 60 years of age,and this may induce a special apoptosis inhibition pathway that differs from that of patients of other age groups.