乳腺癌中环氧合酶2与p53的表达及其与预后的关系

目的探讨环氧合酶2（COX．2）和p53蛋白在乳腺癌组织中的表达及其与乳腺癌预后的关系。方法用免疫组化法检测152例乳腺癌组织和16例正常乳腺组织COX．2和p53蛋白表达情况。通过生存分析研究它们与预后的关系。结果COX．2与p53在正常乳腺组织均不表达。COX．2和p53蛋白在乳腺癌组织中的表达率分别为58．6％（89／152）、61．2％（93／152），二者呈显著相关性（r=0．426，／9〈0．01）；二者表达在Ⅰ、Ⅱ级乳腺癌组织中均显著相关（r值分别为0．414，0．381，均P〈0．01），在Ⅲ级乳腺癌组织中二者无相关性（／9〉0．05）。I、Ⅱ、Ⅲ、Ⅳ期乳腺癌COX-2、p53表达均显著相关（r值分别为0．659，O．557，0。390，0．685，均P〈0．01）。两者表达与淋巴结、远处转移均相关（均／9〈0．05）。COX-2高表达组的5年无进展生存（PFS）率显著低于低表达者，但p53高表达组与低表达组的5年PFS率差异无统计学意义。COX-2与p53均高表达者的5年PFS低于COX-2或p53单一高表达者，亦低于两者均双低表达者。结论COX－2和p53的表达与临床分期、淋巴结转移、远处转移、病理分级等临床预后不良因素有关。检测COX-2和p53对乳腺癌的预后有重要价值。

Expression and prognostic significance of p53 and COX-2 in breast carcinoma tissues

Objective To detect the expression of COX-2 and p53 in breast carcinoma tissue and investigate their associations with clinical prognosis. Methods The expression of COX-2 and p53 was carried out in 16 cases of normal epithelial tissue and 152 cases of breast carcinoma tissue using immunohistoehemistry SP method. The correlation of their expression with clinical characteristics was analyzed using SPSS software 16.0. Survival analysis was used to investigate their effects on tumor prognosis. Results No positive COX-2 and p53 expressions were observed in normal epithelial tissue. Among 152 patients, 89 （58.6 %） were positive staining rete for COX-2 and 93 （61.18 %） were shown p53 expression, with a statistically significant associations between expressions of COX-2 and p53 and breast cancer （r = 0.426, P 〈 0.01）. The COX-2 and p53 expressions were significantly correlated with pathological grade, clinical stage, lymph node or distant organ metastasis. There was a statistically significant correlation between COX-2 and p53 expression and pathological grade I / II. The 5-year progress-free survival （PFS） rate in patients with COX-2 over-expression was 61.3 %, which was remarkably lower than that in those with low COX-2 expression. There was no statistically significant difference of 5-year PFS between positive and negative p53 expression. A shorter 5-year PFS was seen in patients with co-expression of COX-2 and p53 than in those with either COX-2 or p53 positive expression alone and also than in those with both COX-2 and p53 negative expression. Conclusion Detection of the expressions of COX-2 and p53 can be used to predict the prognosis of breast cancer.