COX-2及p53在非小细胞肺癌中表达及临床意义.docVIP

COX-2及p53在非小细胞肺癌中表达及临床意义 　 作者：王志刚　周彩存　欧阳永娥　陈伟文　叶晓艺 【摘要】 　　［目的］ 探讨COX-2和p53蛋白在非小细胞肺癌(NSCLC)中的表达和临床意义。［方法］ 采用免疫组织化学法检测60例NSCLC组织中COX-2与p53蛋白的表达情况。［结果］ COX-2与p53蛋白在NSCLC中阳性表达率分别为56.67%和61.67%。COX-2的表达水平与肺癌的病理类型相关（P=0.009）。COX-2阳性表达的Ⅲ期NSCLC患者中位生存期（MST）和3年生存率均显著低于COX-2阴性表达患者；但p53阳性、阴性表达患者MST和3年生存率无显著性差异。Cox逐步回归分析显示，TNM分期和肿瘤组织COX-2表达水平是NSCLC预后独立因素。［结论］ COX-2的高表达与NSCLC患者预后不良相关。 【关键词】 非小细胞肺癌　免疫组织化学　COX-2　p53　预后 　　 Expressions of COX-2 and p53 in Patients with Non-small Cell Lung Cancer and Their Significance Abstract: ［Purpose］ To investigate the expressions of cyclooxygenase 2(COX-2) and p53 in the patients with non-small cell lung cancer (NSCLC) and their clinical significance. ［Methods］ The expressions of COX-2 and p53 were detected with immunohistochemical staining in 60 cases of NSCLC. ［Results］ The expressions of COX-2 and p53 in NSCLC were 56.67% and 61.67%, respectively. The expression of COX-2 was correlated with pathological types (P=0.009). Median survival time(MST) and 3-year survival in stage Ⅲ patients with positive COX-2 expression were significantly lower than those with negative COX-2 expression, but median survival time and 3-year survival were not significantly different between the patients with positive or negative p53 expression. The Cox-regression analysis showed that TNM staging and COX-2 expression were independent prognostic factors in patients with NSCLC. ［Conclusions］ High expression of COX-2 is related with poor prognosis in NSCLC. Key words: non-small cell lung cancer; immunohistochemistry; cyclooxygenase-2; p53; prognosis 肺癌是临床常见的恶性肿瘤，现已成为人类癌症死亡的最主要原因之一。近年研究表明，COX-2与p53蛋白在许多恶性肿瘤组织中上调表达。临床研究显示，COX-2抑制剂赛来昔布联合紫杉醇治疗非小细胞肺癌（NSCLC）可使患者生存期和疗效得到改善[1]；腺病毒携带野生型p53基因（Ad-p53）治疗NSCLC取得了较好的疗效[2]。本研究应用免疫组化方法检测COX-2和p53蛋白在NSCLC中的表达情况，并探讨它们与NSCLC患者临床病理特征及预后之间的关系。 1 材料与方法 1.1 临床资料 选取根治手术后的NSCLC标本60例，其中男性45例，女性15例；年龄32岁～77岁，中位年龄59岁；腺癌与鳞癌各30例。参照UICC 1997年TNM分期，Ⅰ期15例、Ⅱ期13例和Ⅲ期32例。 1.2 方 法 鼠抗人p53单克隆抗体购自福州迈新公司；兔源性抗COX-2多克隆抗体为美国Caycam Chemical公司的产品。手术石蜡切片经常规脱