NICD及COX-2在胃癌组织中的表达及临床生物学意义
投稿时间:2010-09-20    点此下载全文
引用本文:孙国羊,骆定海,吴建胜,潘钰婷,马升高,张行,金嵘,郑建建.NICD及COX-2在胃癌组织中的表达及临床生物学意义[J].医学研究杂志,2011,40(3):61-66
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作者单位
孙国羊 温州医学院附属第一医院消化内科 
骆定海 温州医学院附属第一医院消化内科 
吴建胜 温州医学院附属第一医院消化内科 
潘钰婷 温州医学院附属第一医院消化内科 
马升高 温州医学院附属第一医院内镜诊疗科 
张行 温州医学院附属第一医院外科实验室 
金嵘 温州医学院附属第一医院流行病学教研室 
郑建建 温州医学院附属第一医院外科实验室 
基金项目:浙江省自然科学基金资助项目(Y2101458)
中文摘要:目的本文旨在研究NICD与COX-2在胃癌组织中的表达及其临床生物学意义。方法通过免疫组化方法检测109例胃癌组织和57例胃癌前病变组织及72例慢性浅表性胃炎组织中NICD和COX-2的表达,分析两者的表达水平与临床病理特征的关系以及两者的相互关系。结果NICD在胃癌组中的阳性率为74.31%(81/109), 明显高于癌前病变组31.58%(18/57)及慢性浅表性胃炎组23.61% (17/72) (χ2=53.45,P<0.01), 与肿瘤大小、分化程度、浸润深度、淋巴结转移有关(χ2=551,P<0.05;χ2=4.76,P<0.05;χ2=4.44,P<0.05;χ2=4.62,P<0.05)。COX-2在胃癌组中的阳性率为71.56% (78/109), 明显高于癌前病变组1.75%(1/57)及慢性浅表性胃炎组0.00% (0/72)(χ2=133.50,P<0.01), 与肿瘤的分化程度、淋巴结转移有关(χ2=20.78,P<0.01;χ2=4.15,P<0.05)。NICD和COX-2在胃癌中表达呈正相关(r=0.30,χ2=9.38,P<0.01) 。Kaplan-Meier分析显示:NICD阳性组2年生存率50.50%,阴性组2年生存率72.80%;COX-2阳性组2年生存率55.10%, 阴性组2年生存率71.40%;NICD阳性COX-2阳性组、NICD阳性COX-2阴性组、NICD阴性COX-2阳性组、NICD阴性COX-2阴性组2年生存率分别为43.10%、100.00%、66.7%、100.00%。生存曲线的log-rank检验显示:NICD与COX-2 阳性对胃癌患者生存率影响有统计学意义(χ2=9.70,P<0.01;χ2=7.95,P<0.01)。Cox回归分析显示:NICD与COX-2可以作为影响胃癌预后的独立因素(χ2=7.55,P<0.05;χ2=4.45,P<0.05)。结论NICD、COX-2在胃癌的发生发展过程中可能起着促癌作用,这两项指标的表达水平可作为评价胃癌预后的指标,联合检测这两项指标在评估胃癌预后方面具有一定的临床价值。
中文关键词:胃肿瘤  NICD  COX-2  免疫组化  预后指标
 
The Expression of NICD and COX-2 in Gastric Carcinoma Tissues and Its Clinical Biological Significance
Abstract:ObjectiveTo investigate the expression and significance of NICD and COX-2 in gastric cancer. MethodsThe expression of NICD and COX-2 in a tissue microarray containing 109 cases of gastric cancer tissues,57 cases of precancerous lesions and 72 cases of chronic superficial gastritis was detected by SP immunohistochemistry.The correlation of NICD expression and COX-2 expression,and their correlation to the clinicophathologic features of gastric cancer was analyzed.ResultsThe postive rate of NICD was significantly higher in gastric cancer than that in precancerous lesions and chronic superficial gastritis (74.31% vs 31.58%,74.31% vs 2361% separately;χ2=28.39,P<0.01;χ2=44.89,P<0.01), and closely related to tumor size (χ2=5.51,P<0.05), differentiation grade (χ2=4.76,P<0.05), depth of invasion (χ2=4.44,P<0.05)and lymph node metastasis (χ2=4.62,P<0.05).The positive rate of COX-2 was significantly higher in gastric cancer than in precancerous lesions and chronic superficial gastritis (71.56% vs 175%,71.56% vs 0.00% separately;χ2=73.12,P<0.01,χ2=90.54,P<0.01),and closely related to differentiation grade(χ2=2078,P<0.01) and lymph node metastasis(χ2=4.15,P<0.05).The expression of NICD was positively correlated to that of COX-2(r=0.30,χ2=9.38,P<0.01).The 2-year survival rate was significantly higher in NICD(-)group ( NICD-negative) than in NICD(+)group (NICD-positive) (72.80% vs 50.50%;χ2=9.70,P<0.01), and was significantly higher in COX-2(-)group(COX-2-negative) than in COX-2(+)group (COX-2-positive) (71.40% vs 55.10%;χ2=7.95,P<0.01). The 2-year survival rates of NICD(+)COX-2(+) group, NICD(+) COX-2(-) group, NICD(-) COX-2(+) group,and NICD(-) COX-2(-)group were 43.10%,100.00%,66.7%,100.00% separately. COX regression analysis showed that NICD expression and COX-2 expression were independent prognostic factors of gastric cancer(χ2=7.55,P<0.05;χ2=4.45,P<0.05). ConclusionThe dys-regulation of NICD and COX-2 expression may correlate to the occurrence and development of gastric cancer. NICD and COX-2 may be novel prognostic markers of gastric cancer. Combined detection of these two indicators has some clinical value in assessing the prognosis of gastric cancer.
keywords:Gastric neoplasm  NICD  COX-2  Immunohistochemistry  Prognostic factor
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