环氧化酶-2及血管内皮生长因子在宫颈癌及其癌前病变中的表达

目的探讨环氧化酶-2（cyclooxygenenase-2，COX-2）的表达与宫颈癌发生的关系以及COX-2与血管内皮生长因子vascular endothelial growth factor，VEGF）表达的关系。方法采用免疫组化（S-P）法检测20例正常宫颈、26例低度宫颈上皮内瘤变（cervical intraepithelial neoplasia，CIN；CIN Ⅰ）、28例高度CIN（CIN Ⅱ／Ⅲ）、25例宫颈癌组织中COX-2、血管内皮生长因子vascular endothelial growth faclor，VEGF）的表达，并分析COX-2与VEGF及高危HPV感染的关系。结果在正常宫颈、低度CIN、高度CIN、宫颈癌中COX-2的表达率分别为0、23．08％、57．14％、84％，VEGF的表达率分别为5％、30．77％、60．71％、88％，两者均随着病变的加重表达率明显增加，差异均有统计学意义（P〈0．001）。COX-2表达与VEGF呈显著正相关（P=0．001）。人乳头瘤病毒（HPV）在低度CIN、高度CIN及宫颈癌的感染率分别为30．77％、71．43％、100％，在宫颈癌及其癌前病变中，COX-2与高危HPV感染率呈正相关（P=0．021）。结论COX-2与宫颈癌的发生、发展有关，并可能与肿瘤的血管生成有密切的关系。COX-2可能成为宫颈癌早期防治的靶点。

Cyclooxygenenase-2 and Vascular Endothelial Growth Factor Expression in Cevial Cancer and Cervical Precancerous Lesions

Objective To explore the expression of cyclooxygenenase-2 （COX-2） in cervical carcinogenesis and to analyze the correlation of the expression of COX-2 and vascular endothelial growth factor （VEGF）. Method COX-2 and VEGF expression were examined by S-P immunohistochemisty in 20 cases of benign cervix, 26 low-grade cervical intraepithelial neoplasia （CIN; CIN Ⅰ ）, 28 high-grade CIN （CIN Ⅱ/Ⅲ ） and 25 cervical cancer. The correlations of COX-2, VEGF and high-risk human papillomavirus（HPV）infection were analyzed. Result Positive detection rates in normal cervix, low-grade CIN, high-grade CIN and cervical cancer for COX-2 were 0, 23.08%, 57.14% and 84%, respectively; for VEGF were 5%, 30.77%, 60.71% and 88%, respectively. COX-2 and VEGF detection rates were significantly increased in parallel to the severity of CIN and invasive disease（P〈0.001 ）. COX-2 expression was statistically correlated to VEGF expression （P=0.001）. The human papillomavirus （HPV） infection rates in low-grade CIN, high-grade CIN and invasive disease were 30.77%, 71.43% and 100%, respectively and was statistically correlated to COX-2 expression（P=0.021）. Conclusion On the basis of our findings, COX-2 expression may participate in the development and progression of cervical precancerous lesions to invasive desease and correlate with angiogenesis. COX-2 may be a potential molecular target for cervical cancer prevention and treatment.