环氧化酶2及核因子κB在胃黏膜相关淋巴瘤组织中的表达及其临床意义

目的探讨环氧化酶2（COX-2）及核因子κB（NF—κB）蛋白在胃黏膜相关（MALT）淋巴瘤组织中的表达及其临床意义。方法采用Envision二步法检测47例MALT淋巴瘤组织中COX-2和NF—κB蛋白的表达，并对其与幽门螺杆菌（Hp）感染、肿瘤大小和临床病理分期及浸润深度等指标的相关性进行分析。结果本组MALT淋巴瘤组织中COX-2和NF—κB蛋白阳性表达率分别为48．9％（23／47）和36．2％（17／47），两者表达呈正相关关系（r=0．326，P〈0．05）；COX-2表达与伽感染、肿瘤临床病理分期和浸润深度及肿瘤大小明显相关（P〈0．05）。生存分析显示，COX-2阳性组病例的存活时间（59．9个月）短于阴性组（77．8个月），但两组间差异无统计学意义（P〉0．05）；NF—κB阳性组病例的存活时间（26个月）显著短于阴性组（123．2个月），差异具有统计学意义（P〈0．05）。肿瘤临床病理分期是胃MALT淋巴瘤预后的独立影响因素（风险度为3．041，回归系数为1．112，Wald统计量为13．985，P〈0．01），且与预后呈负相关；而COX-2和NF—κB均不是影响预后的独立因素。结论COX-2表达上调和NF-κB激活与胃MALT淋巴瘤伽感染有关，且表达水平与肿瘤进展及预后密切相关。

Protein expression and clinical significance of cyclooxygenase 2 and nuclear factor kappa B in gastric mucosa-associated lymphoid tissue lymphoma

OBJECTIVE: To investigate the protein expression of cyclooxygenase 2 (COX-2) and nuclear factor kappa B (NF-kappaB) in gastric mucosa-associated lymphoid tissue (MALT) lymphoma and its clinical significance. METHODS: Protein expression of COX-2 and NF-kappaB in gastric MALT lymphoma were examined by immunohistochemistry of Envision two-step method. The correlations of COX-2 and NF-kappaB expression with Helicobacter pylori (Hp) infection, clinical stage, depth of tumor invasion, tumor size, recurrent rate and treatment were analyzed by univariate, multivariate and Pearson analysis. RESULTS: The positive expression of COX-2 and NF-kappaB in gastric MALT lymphoma were 48.9%(23/47) and 36.2% (17/47) respectively, and a positive correlation was found between these two factors(r=0.326,P<0.05). Moreover, COX-2 expression was positively correlated with Hp infection,clinical stage, depth of invasion and tumor size (P<0.05). Univariate analysis showed that the overall survival of gastric MALT lymphoma patients with positive COX-2 protein (59.9 months) was shorter than that of patients with negative COX-2 protein (77.8 months), but the difference was not significant (P>0.05). The survival was significantly shorter in gastric MALT lymphoma patients with positive NF-kappaB protein (26 months) than that of patients with negative NF-kappaB protein (123.2 months)(P<0.05). Multivariate Cox regression analysis revealed that clinicopathological stage was independent prognostic factor, and associated with short survival. CONCLUSION: Up-regulated expression of COX-2 and activation of NF-kappaB are associated with Hp infection in gastric MALT lymphoma, and their protein expression is correlated with the development of tumor and prognosis.