环氧化酶2和血管内皮生长因子在乳腺浸润性导管癌中的表达及其临床意义

目的 探讨环氧化酶2（COX-2）、血管内皮生长因子（VEGF）mRNA及其蛋白在乳腺浸润性导管癌中的表达及其与临床病理特征的关系.方法 采用原位杂交和免疫组织化学技术检测70例乳腺浸润性导管癌和30例乳腺纤维腺瘤中COX-2、VEGF mRNA及蛋白的表达.计数资料的分析运用χ2检验,相关性分析采用Spearman检验.结果 乳腺浸润性导管癌COX-2 mRNA阳性率明显高于乳腺纤维腺瘤74.2%（52/70）比30.0%（9/30）,χ2=17.31,P=0.00],COX-2 蛋白阳性率也明显高于乳腺纤维腺瘤72.8%（51/70）比23.3% （7/30）,χ2=21.14,P=0.00].乳腺浸润性导管癌COX-2 mRNA及蛋白的表达均与淋巴结转移有关（χ2=7.54,P=0.00;χ2=6.36,P=0.01）,与年龄、肿瘤大小和组织学分级无关（P〉0.05）.乳腺浸润性导管癌VEGF mRNA阳性率明显高于乳腺纤维腺瘤71.4%（50/70）比33.3% （10/30）,χ2 =12.70,P=0.00],其VEGF蛋白阳性率也明显高于乳腺纤维腺瘤65.7%（46/70）比26.7%（8/30）,χ2 =12.89,P=0.00].乳腺浸润性导管癌VEGF mRNA表达与淋巴结转移有关（χ2=8.33,P=0.00）,与年龄、肿瘤大小及组织学分级无关（P〉0.05）;而VEGF蛋白表达与组织学分级、淋巴结转移有关（P〈0.05）,与年龄及肿瘤大小无关（P〉0.05）.在乳腺浸润性导管癌中,COX-2 mRNA表达与VEGF mRNA表达之间以及COX-2蛋白表达与VEGF蛋白表达之间均呈正相关关系（r=0.64,P=0.00;r=0.44,P=0.00）.结论 COX-2和VEGF的mRNA及蛋白在乳腺浸润性导管癌中表达均上调且与淋巴结转移有关,因此,COX-2、VEGF可作为判断乳腺浸润性导管癌预后的生物学标志物.

Expressions of COX-2 and VEGF in breast invasive ductal carcinoma and their clinical significance

Objective To investigate the mRNA and protein expressions of cyclooxygenase-2 （COX-2） and vascular endothelial growth factor （VEGF） in breast invasive ductal carcinoma and analyze their relationship with elinieopathological characteristics. Methods The mRNA and protein expressions of COX-2 and VEGF were detected in 70 cases of breast invasive ductal carcinoma and 30 cases of breast fibroadenoma using in situ hybridization and immunohistoehemieal SP method. The enumeration data were analyzed by X2 test. The correlation analysis was performed by Spearman test. Results The positive rate of COX-2 mRNA in breast invasive ductal carcinoma （74. 2%, 52/70 ） was significantly higher than in breast fibroadenoma （30.0%, 9/30） （X2= 17.31, P = 0. 00）. The positive rate of COX-2 protein in breast invasive duetal carcinoma （72.8%, 51/70） was significantly higher than that in breast fibroadenoma （23.3% , 7/30） （ X2 = 21.14, P=O. 00）. In breast invasive ductal carcinoma, COX-2 mRNA and protein expressions were related to lymphatic metastasis （ X2 = 7. 54, P = O. 00 ; X2 = 6.36, P = 0.01 ）, but not related to age, tumor size and histopathological grade. The positive rate of VEGF mRNA in breast invasive ductal carcinoma （71.4%, 50/70） was significantly higher than that in breast fibroadenoma （ 33.3% , 10/30 ） （ X2 = 12.70, P = 0.00 ）. The positive rate of VEGF protein in breast invasive ductal carcinoma （65.7%, 46/70） was significantly higher than that in breast fibroadenoma （26.7% , 8/30） （X2= 12.89,P=0.00）. The expression of VEGF mRNA in breast invasive ductal carcinoma was related to lymphatic metastasis （ X2 = 8.33, P = 0.00 ）, but not related to age, tumor size and histopathological grade （ P 〉 0.05 ）. VEGF protein expression was related to lymphatic metastasis and histopathological grade （ P 〈 0.05 ）, but not related to age and tumor size （ P 〉 0. 05 ）. The mRNA and protein expressions of VEGF were positively correlated with the mRNA and protein expressions of COX-2 in breast invasive ductal carcinoma （r=0. 64,P=0. 00,r=0. 44,P=0.00）. Conclusion The mRNA and protein expressions of COX-2 and VEGF are up-regulated in breast invasive ductal, which is related to lymphatic metastasis, therefore, COX-2 and VEGF can be considered as biological markers for the prognosis of breast cancer.