COX-2、u—PA、TSP-1、MLD、MVD在胃癌中的表达及对生存期的影响

目的研究环氧合酶2（COX-2）、尿激酶纤溶酶原激活物（U—PA）、血小板反应素-1（TSP-1），微血管密度（MVD），微淋巴管密度（MLD）在胃癌组织表达，探讨与生存期关系。方法调查患者的生存期，用组织芯片技术和免疫组化法检测胃癌组织COX-2、u—PA、TSP-1、MVD和MLD的表达，分析对生存期的影响，另设同期30例浅表性胃炎作为对照组。结果COX．2、U—PA、TSP-1在胃癌组阳性率均显著高于对照组（P〈0．05）；胃癌组MVD、MLD均显著高于对照组（P〈0．05）；U．PA阳性、COX-2和U—PA双阳性、MVD高表达、弥漫型、肿瘤直径≥5cm、淋巴结转移、低分化、肿瘤浸润至浆膜层及以外组的平均生存期显著低于对照组（P〈0．05）；Cox回归分析淋巴结转移、浸润深度、U—PA和COX-2双阳性表达是影响患者生存期的独立危险因素（P〈0．05）。结论COX-2、u—PA、TSP-1在胃癌组织呈高表达，淋巴结转移、浸润深度、U-PA和COX-2双阳性表达是影响患者生存期独立的预后因素。

Expression of COX-2 u-PA,TSP-1 MLD,MVD in gastric carcinoma and effect on the survival time

Objective Investigate the expression of eyclooxygenase- 2 （ COX- 2 ）, urokinase plasminogen activator （ u- PA ） , thrombospondin- 1 （ TSP- 1 ） , microvessel density （MVD） and microlymphatic vessel density （ MLD ） in gastric carcinoma, analyze the relationship with patient＇ s survival time. Methods Patient＇ s survival time were collected. Samples were made into tissue microarray. Expression of COX- 2, u- PA, TSP- 1, MLD, MVD in samples were examined by S- P immunohistochemistry staining and the relationship between their expression and patient＇ s survival time were analyzed by statistics. 30 cases of super- ficial gastritis were used as control. Results ：The positive expression rate of COX-2, u-PA, TSP-1 in gastric carcinoma were higher than that in control group （ P 〈 0. 05 ）. The expression of MVD and MLD in gastric carcinoma were higher than that in control group （ P 〈 0. 05 ）. Patient＇ s survival time in the group of u-PA positive, COX-2 and u-PA double positive,high expres- sion of MVD, Lauren type, diameter of tumor 〉15 cm,lymph node metastasis, depth of invasion out of serosa,low differentiated were shorter than that in control group （ P 〈 0. 05 ）. Cox multiple regression showed that lymph node metastasis, depth of inva- sion, COX-2 and u-PA double positive acted as an independent risk factors in affecting patient survival（ P 〈 0. 05 ）. Conclusion COX-2 ,u-PA,TSP-1 was highly expressed in gastric carcinoma. Lymph node metastasis,depth of invasion and COX-2 and u- PA double positive can be used as an independent prognostic factor.