环氧化酶2在反流性食管炎和食管癌中的表达

目的 检测环氧化酶2(COX-2)在反流性食管炎和食管癌中的表达,探讨其与临床病理的关系.方法 应用免疫组化染色法检测并以计分法判定35例反流性食管炎胃镜活检组织、89例手术切除的食管癌组织和20例正常食管黏膜组织COX-2的表达.分析反流性食管炎中COX-2的表达与年龄、性别、不典型增生的程度和内镜下分级等临床病理的关系.分析食管癌中COX-2的表达与肿瘤部位、病变长度、浸润深度、区域淋巴结转移、远处转移、鳞癌分化程度等临床病理参数的关系.结果 COX-2在正常食管黏膜、反流性食管炎、食管癌中的表达率分别为60.00%、88.57%、94.38%,且食管癌组着色最强、正常食管组着色最弱.反流性食管炎中,COX-2的表达与不典型增生呈正相关(r,=0.490,P<0.01);食管癌中,COX-2的表达与肿瘤浸润深度呈正相关(rs=0.215,P<0.05),与鳞癌细胞分化程度呈负相关(rs=-0.427,P<0.01).COX-2的表达与其它临床病理参数,包括性别、年龄、反流性食管炎内镜下分级、食管癌生长部位、大小、区域淋巴结转移、远处转移无关.结论 COX-2在正常食管黏膜、反流性食管炎、食管癌组织中的表达呈逐级上调的趋势.反流性食管炎不典型增生越严重,COX-2的表达越强;食管癌肿瘤浸润越深、鳞癌分化程度越低,COX-2的表达越强.

Expressions of cyclooxygenase-2 in reflux esophagitis and esophageal carcinoma

Objective To examine cyclooxygenase-2(COX-2) expression in reflux esophagitis(RE) and esophageal carcinoma, and to explore the relationships of COX-2 expression to elinicopathological features. Methods Thirty-five RE biopsy specimens were collected, and their clinicopathological features such as age, sex, dysplasia, grade according to the endoscope were recorded. Eighty-nine paraffin-embedded tissue samples from patients with esophageal carcinoma were collected, and their clinicopathological features such as length and site of the tumor, depth of invasion, regional lymph node metastases,distant metastasis, tumour differentiation were also recorded. Twenty normal esophageal tissues were used as control. The expression of COX-2 of above 3 kinds of tissues were examined by immunohistochemistry and semi-quantitative scoring method, and the relationships between COX-2 expression and clinicopathological features were analysed. Results COX-2 expression rates in normal esophagus, RE and esophageal carcinoma were 60.00%, 88.57% and 94.38% respectively. The expression of COX-2 was the highest in esophageal carcinoma, and the weakest in normal esophagus. Correlation analysis showed positive correlation of COX-2 expression to dysplasia in RE (rs=0.490, P<0.01), and depth of invasion in esophageal carcinoma (rs=0.215, P<0.05), meanwhile negative correlation of COX-2 expression to tumour differentiation in esophageal carcinoma (rs=-0.427, P<0.01). There was no correlation between COX-2 expression and other clinicopathological features,such as age,sex, grade according to the endoscope, length and site of the tumor, regional lymph node metastases and distant metastasis. Conclusion COX-2 expression increases gradually in normal esophagus, RE and esophageal carcinoma. COX-2 expression increases with the increase of dysplasia in RE, and increases with decrease of tumour differentiation and the increase of depth of invasion in esophageal carcinoma.