HuR VEGF和COX-2 表达及临床病理因素与早期宫颈癌患者预后关系的分析

目的：分析和评价临床病理因素（年龄、临床分期、病理类型、组织学分级、癌灶大小、淋巴结转移）和生物学因素（HuR 、VEGF及COX-2）与早期（Ⅰ～Ⅱ期）宫颈癌手术预后的关系。方法：采用免疫组化方法检测早期宫颈癌组织中HuR 、VEGF及COX-2 蛋白的表达，将可能与预后有关的因素进行单因素分析后再进行多因素分析。结果：癌灶大小、HuR 蛋白阳性表达、COX-2 蛋白阳性表达与预后相关（P 均<0.05）；临床分期、组织学分级、有无淋巴结转移、VEGF蛋白阳性表达与预后明显相关（P均≤0.01），不同年龄、病理类型与预后无关（P 均>0.05）。 组织学分级低者5 年累计生存率显著低于组织学分级高者，前者死亡危险度是后者的2.948 倍，是影响宫颈癌手术预后的第一位独立因素。其次为VEGF阳性表达，其相对危险度为2.801。结论：早期宫颈癌手术预后与临床分期、组织学分级、癌灶大小、有无淋巴结转移、HuR 蛋白阳性、VEGF蛋白阳性、COX-2 蛋白阳性有关，与年龄、病理类型无关。组织学分级、VEGF蛋白阳性是影响宫颈癌手术预后最显著的独立因素。

Correlation among HuR,VEGF and COX- 2 Expressions,Clinicopathologic Factors and Prognos is of Early (Stage-I~II) Cervical Cancer

Objective: To analyze and evaluate the correlation among the common clinico-pathologic characteristics such as age, clinical staging, pathological type, histological grading, tumor size, nodal metastasis; the biological factors such as HuR, VEGF and COX- 2; and the prognosis of early (Stage I-II) cervical carcinoma. Methods:Immunohistochemical staining was used to detect the expression of HuR protein, VEGF protein and COX-2 protein in early (Stage I-II) cervical carcinoma. Univariate analysis of the factors that might be in relation to the prognosis of the early cancer patients was con-ducted. Based on these results, multi variate analysis was then conducted using the COX proportional hazards regression model.Results: We found that tumor size and the expression of HuR and COX-2 proteins are all in relation to the prognosis of early (Stage I-II) cervical cancer (all P<0.05), and all clinical characteristics such as staging, histological grading, lymph node transmission and VEGF protein expression are significantly correlated with the prognosis of early (Stage I-II) cervical cancer (all P≤0.01). Contrarily, age and pathological type are not in relation to the prognosis of early (Stage I-II) cervical cancer ( P>0.05). The cumulative five-year survival rate was significantly lower in patients with low histological grades than in those with high histological grades. The risk of death of the former was 2.948 times higher compared to the latter. So, his-tological grading is the first independent factor that affects the prognosis of early cervical cancer. VEGF expression is the next independent factor, and the relative risk is 2.801 . Conclusion:The prognosis of early (Stage I-II) cervical cancer is cor -related with clinical staging, histological grading, tumor size, nodal metastasis, the HuR protein expression, and the VEGF and COX-2 protein expressions, but not correlated with age or pathological types. Histological grade and VEGF protein ex-pression are the two most significant independent factors for prognosis of early (Stage I-II) cervical cancer.