胃癌组织COX-2、VEGF-C表达与淋巴结转移及预后关系的研究

目的:探讨环氧化酶-2(cyclooxygenase-2,COX-2)、血管内皮生长因子C(VEGF-C)在胃癌组织中的表达及其与淋巴管生成、淋巴结转移及预后的关系.方法:采用免疫组织化学SABC法检测 51例胃癌及相应的癌旁组织COX-2、VEGF-C及受体VEGFR-3表达,计数肿瘤内淋巴管密度(LVD),并结合临床病理特征和随访资料进行分析.结果:胃癌组织COX-2、VEGF-C表达阳性率分别为62.8%(32/51),60.7%(31/51).COX-2表达与VEGF-C(r=O.74,P＜0.05)、临床分期(r=0.34,P＜0.05)、淋巴管密度(r=0.69,P＜0.01)和淋巴结转移(r=0.57,P＜0.01)呈正相关,与病理分化呈负相关(r=-0.58,P＜0.01).VEGF-C表达与淋巴管密度(r=0.45,P＜0.01)、淋巴结转移呈正相关(r=0.46,P＜0.05).随访5年,胃癌组织COX-2表达与生存率呈负相关,COX-2表达阴性组5年生存率(36.8%)显著高于COX-2表达阳性组(15.6%)(P＜0.05).结论:在胃癌组织中,COX-2、VEGF-C高表达,COX-2与VEGF-C、淋巴管密度、淋巴结转移呈正相关.推测COX-2通过诱导VEGF-C表达参与淋巴结转移.胃癌组织COX-2检测可能对推测预后具有重要意义.

The Expression of COX-2 and VEGF-C in Gastric Cancer and the Correlation with Lymph Node Metastasis and Prognosis

Objective: To investigate the expression of cyclo- oxygenase-2 (COX-2) and vascular endothelial growth factor(VEGF-C) in gastric cancer and the correlation with lymphangiogenesis, lymph node metastasis and prognosis. Methods: The expression of COX-2, VEGF-C and it's receptor, VEGFR-3, was evaluated in 51 cases with gastric cancer and 15 paraneoplastic tissue specimens by immunohistochemical staining SABC methods. The lymphatic vessels density (LVD) in tumor was counted and analyzed with clinicopathologic parameters. Results: The positive rate of COX-2 and of VEGF-C was 62.8% and 60.7% respectively in gastric cancer tissue. The expression of COX-2 was positively correlated with VEGF-C (r=0.74, P<0.01), clinical stage (r=0.34, P<0.05), LVD(r=0.69, P<0.01) and lymph node metastasis (r=0.57, P<0.01), but was negatively correlated with pathologic differentiation (r=-0.58, P<0.01). The expression of VEGF-C was positively correlated with LVD(r=0.45, P<0.01) and lymph node metastasis (r=0.46, P<0.05). COX-2 expression was negatively correlated with a 5-year survival rate. The 5-year survival of patients with negative COX-2 expression was significantly higher compared to that with positive COX-2 expression (P<0.05). Conclusions: In gastric cancer, the expression rate of COX-2 and VEGF-C was high. COX-2 expression was positively correlated with VEGF-C, LVD and lymph node metastasis. It is presumed that COX-2 can promote the metastasis of lymph node in tumor by inducing VEGF-C expression, and the detection of COX-2 in gastric cancer tissues will be of significance for prediction of the prognosis.