胃癌组织中环氧合酶2、Ki-67、微血管密度及临床病理因素对胃癌复发的影响

目的研究胃癌组织中环氧合酶2（COX-2）、Ki-67的表达和微血管密度（MVD）及其与临床病理因素的相互关系,探讨影响胃癌复发的因素.方法回顾性分析48例胃癌复发病例的临床病理特征,并以48例无复发病例作为对照.用免疫组织化学方法检测胃癌标本中COX-2、Ki-67的表达和MVD,并分析三者之间及其与临床病理因素的相关性.用单因素和多因素分析影响胃癌复发的相关因素.结果胃癌组织中COX-2、Ki-67的表达与MVD两两之间高度相关,并且都与浸润深度和TNM分期密切相关.复发组病例术前存在盆腔转移结节、浸润深度达浆膜或浆膜以外以及Borrmann分型Ⅲ型和Ⅳ型的比例明显增多,COX-2高表达和MVD明显增多,差异具有统计学意义（P＜0.05）.浸润深度、盆腔转移结节、COX-2高表达和MVD是胃癌复发的高危因素.结论COX-2高表达、MVD、浸润深度、盆腔转移结节是胃癌复发的独立影响因素.

Effect of COX-2 and Ki- 67 expression and tumor microvessel density in primary gastric cancer tissue and clinicopathological parameters on postoperative gastric cancer recurrence

Objective To explore the correlation between COX-2 and Ki-67 expression and microvessel density in primary gastric cancer tissue and clinicopathological parameters and to investigate their effect on postoperative gastric cancer recurrence. Methods Forty-eight postoperative recurrent gastric cancer patients were enrolled in this study, their clinicopathologic characters of primary tumors were analyzed retrospectively and compared with 48 cases without recurrence. Expression of COX-2 and Ki-67 and microvessel density ( MVD) in gastric cancer tissue were detected by immunohistochemical method. Risk factors correlated with tumor recurrence were studied by univariate and multivariate analysis. Results Expression of COX-2, Ki-67 label index (LI) and MVD were correlated with each other, and they were all correlated with depth of invasion and TNM stages in gastric cancer tissue. Patients with pelvic metastatic lymph node, cancer invasion to serosa, of Borrmann III or IV, high COX-2 and MVD expression are on high risk of recurrence (P < 0.05). Multivariate analysis shows cancer invasion depth, pelvic lymph node metastases, high expression of COX-2 and MVD were risk factors indicating tumor recurrence. Conclusion High expression of COX-2, MVD and depth of cancer invasion and pelvic lymph node metastasis are independent risk factors of postoperative gastric cancer recurrence.