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目的:探讨环氧化酶-2(cyclooxygenase-2,COX-2)、血管内皮生长因子C(VEGF-C)在胃癌组织中的表达及其与淋巴管生成、淋巴结转移及预后的关系。方法:采用免疫组织化学SABC法检测51例胃癌及相应的癌旁组织COX-2、VEGF-C及受体VEGFR-3表达,计数肿瘤内淋巴管密度(LVD),并结合临床病理特征和随访资料进行分析。结果:胃癌组织COX-2、VEGF-C表达阳性率分别为62.8%(32/51),60.7%(31/51)。COX-2表达与VEGF-C(r=0.74,P<0.05)、临床分期(r=0.34,P<0.05)、淋巴管密度(r=0.69,P<0.01)和淋巴结转移(r=0.57,P<0.01)呈正相关,与病理分化呈负相关(r=-0.58,P<0.01)。VEGF-C表达与淋巴管密度(r=0.45,P<0.01)、淋巴结转移呈正相关(r=0.46,P<0.05)。随访5年,胃癌组织COX-2表达与生存率呈负相关,COX-2表达阴性组5年生存率(36.8%)显著高于COX-2表达阳性组(15.6%)(P<0.05)。结论:在胃癌组织中,COX-2、VEGF-C高表达,COX-2与VEGF-C、淋巴管密度、淋巴结转移呈正相关。推测COX-2通过诱导VEGF-C表达参与淋巴结转移。胃癌组织COX-2检测可能对推测预后具有重要意义。
Objective: To investigate the expression of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor C (VEGF-C) in gastric carcinoma and their relationship with lymphangiogenesis, lymph node metastasis and prognosis. Methods: The expressions of COX-2, VEGF-C and VEGFR-3 were detected by immunohistochemical SABC method in 51 cases of gastric cancer and their adjacent tissues. The lymphatic vessel density (LVD) in the tumor was counted. Combined with clinicopathological features and follow-up Data analysis. Results: The positive rates of COX-2 and VEGF-C in gastric cancer tissues were 62.8% (32/51) and 60.7% (31/51), respectively. The expression of COX-2 was positively correlated with the expression of VEGF-C (r = 0.74, P <0.05) P <0.01), but negatively correlated with pathological differentiation (r = -0.58, P <0.01). The expression of VEGF-C was positively correlated with lymphatic vessel density (r = 0.45, P <0.01) and lymph node metastasis (r = 0.46, P <0.05). After 5 years of follow-up, the expression of COX-2 in gastric cancer tissues was negatively correlated with the survival rate. The 5-year survival rate (36.8%) in COX-2 negative patients was significantly higher than that in COX-2 positive patients (15.6%, P <0.05). CONCLUSIONS: COX-2 and VEGF-C are highly expressed in gastric cancer tissues, and there is a positive correlation between COX-2 and VEGF-C, lymphatic vessel density and lymph node metastasis. It is speculated that COX-2 is involved in lymph node metastasis by inducing VEGF-C expression. The detection of COX-2 in gastric cancer may be of great significance for the prediction of prognosis.