胃黏膜病变组织COX-2蛋白表达的研究

目的：研究胃黏膜病变组织中环氧化酶－2（COX－2）蛋白的表达，探讨其与胃癌类型，分期，分化，转移及幽门螺杆菌（Hp)感染之间的内在关系。方法：外科手术中取30例胃癌者的癌组织，癌旁非癌组织各两块，石蜡包埋，切片HE染色作病理及免疫组织化学检查COX－2蛋白表达，Hp阳性感染由快速尿素酶试验结合病理染色／^14C尿素呼气试验而确立。结果：COX－2在胃癌中阳性表达率（66．7％），癌旁组织（26．7％），差异具有显著性（P＜0．01），其表达强度差异也有非常显著性意义（P＜0．001）。COX－2蛋白阳性表达率；进展期胃癌（76．0％）显著高于早期胃癌（20．0％）（P＜0．05）；有淋巴结转移（79．2％）显著高于无淋巴结转移（16．7％）（P＜0．05）；肠型胃癌（66．7％）与胃型胃癌（66．7％），低，未分化癌（80．0％）与高、中分化癌（57．1％），相比统计学上均无显著性差异（P＞0．05）。Hp阳性肠化或异型增生组COX－2的表达显著高于Hp阴性组（P＜0．05）。结论：COX－2蛋白在胃癌有较高水平的表达，它的异常表达多与胃癌的进展及淋巴结转移有关而与胃癌类型，病理学上分化程度关系上。COX－2基因在胃癌早期发生发展过程中可能起重要的作用，并与Hp感染有一定关系。

The expression of COX-2 proteins in gastric mucosal lesions

Objective To investigate the expression of COX 2 proteins in gastric mucosal lesions and to assess the relationship between expression of COX 2 and type,pathologic stage,differentiation,or lymph node metastasis in gastric cancer and the relationship between expression of COX 2 and H.pylori infection in gastric mucosal lesions.Methods 30 patients with gastric carcinoma underwent surgical resection.Samples were taken from tumor site and paracancerous tissues,and ABC immunohistochemical staining was used to detect the expression of COX 2 proteins.H.pylori was determined by rapid urea test combined with pathological stating/ 14 C urea breath test.Results The positive rate and staining intensity of mutant COX 2 gene expression in gastric cancer were significantly higher than those in paracancerous tissues ( P <0 01, P <0 001);There was significant correlation between COX 2 and pathologic stage or lymph node metastasis type of gastric carcinoma(p all<0 05);No correlation between COX 2 expression and type or grade of differentiation(p all>0 05).COX 2 expression of IM or DYS with H.pylori positive was significantly higher than that with H.pylori negative ( P <0 05).Conclusion Overexpression of COX 2 was found in a large proportion of gastric cancer tissues compared with matched non cancerous tissues and was significantly associated with advanced tumor stage and lymph node metastasis.Overexpression of COX 2 plays an importamt role in tumor progression of gastric cancer.COX 2 may also play a role in the early development/progress of gastric carcinoma and are associated with H.pylori infection.