环氧化酶-2在乳腺癌中高表达的临床意义.DOCVIP

临床医学论文-环氧化酶-2在乳腺癌中高表达的临床意义 ?????????? 作者：胡春宏　文芳　邓超　马芳 【摘要】? 　　［目的］ 探讨环氧化酶-2（COX-2）在乳腺癌组织中的表达及其与临床病理因素和预后的相关性。［方法］ 应用免疫组织化学方法检测60例乳腺癌石蜡包埋组织中COX-2、HER-2/neu和血管内皮生长因子(VEGF)的表达。［结果］ 60例乳腺癌组织中COX-2的高表达率为38.3％（23/60）。在淋巴结转移阳性组和阴性组以及不同临床分期病人COX-2的表达差异有显著性(P＜0.05)；COX-2的表达与HER-2/neu、VEGF表达密切相关（P＜0.01)。COX-2和HER-2/neu共同表达的患者TNM分期较晚。COX-2低表达的患者总生存期较长，与高表达患者的总生存期有显著性差异（P＜0.05)。［结论］ 乳腺癌组织中COX-2的高表达可提示乳腺癌恶性程度高和预后不良，COX-2和HER-2/neu同时高表达预后更差。 【关键词】? 乳腺肿瘤　环氧化酶-2　HER-2/neu　血管内皮生长因子　免疫组织化学 　　 High Expression of COX-2 in Breast Cancer and its Clinical Significance ????? Abstract: ［Purpose］ To explore the expression of cyclooxygenase-2(COX-2) and its correlation with clinicopatholgical factors and prognosis in breast cancer. ［Method］ Paraffin imbedding tissues from 60 cases with breast cancer were detected for expression of COX-2, HER-2/neu and VEGF by immunohistochemistry. ［Results］ The expression of COX-2 increased in 23/60 patients (38.3%), which was significant difference between positive lymph node and negative one, and between different TNM stages (P0.05). The expression of COX-2 corresponded to the expression of HER-2/neu and VEGF(P0.01). The co-expression of COX-2 and HER-2/neu indicated the breast cancer in advanced TNM stage. The overall survival of patients with low expression of COX-2 was longer than that with high expression(P0.05). ［Conclusion］ High expression of COX-2 in breast cancer tissue suggests aggressive potential and? poor prognosis, co-expression of COX-2 and HER-2/neu? even worse. ??? Key words: breast neoplasms; cyclooxygenase-2; HER-2/neu; VEGF; immunohistochemistry ??? 近20年的观察与研究发现，长期服用NSAID可降低乳腺癌的发病率，而NSAID作用的重要靶分子是环氧化酶(COX)。环氧化酶是分解花生四烯酸，合成不稳定前列腺素的限速酶，它有两种类型：COX-1和COX-2。COX-1是一种结构型酶，以稳定水平存在于许多正常组织中，被称为“看家基因(housekeeping gene)”；COX-2是一种诱生型酶，静息状态时不易检测到，在受到各种细胞因子、生长因子及肿瘤启动因子等的刺激后，COX-2的表达水平可迅速升高，COX-2又被称为“快速早期反应基因（immediate to early gene）”[1]。原癌基因HER-2/neu是表皮生长因子受体家族成员之一，VEGF在肿瘤的新生血管的生成中发挥重要作用，两者都是乳腺癌的重要预后指标。本研究旨在观察与探讨COX-2在乳腺癌中的高表达与临床病理指标及预后的关系，尤其是与HER-2/neu