CAJ | 학술논문

目的探讨环氧合酶2(COX-2)和端粒酶在食管癌组织和手术切缘中的表达及其临床意义,分析其在食管癌中的诊断和预后价值.方法应用组织芯片技术和免疫组织化学EnVision法检测82例食管癌患者肿瘤标本及手术切缘组织和40例正常食管上皮组织(NEET)中COX-2和端粒酶的表达情况,并分析其与临床病理诸因素之间及预后的关系.结果 82例食管癌组织中COX-2阳性68例(82.9％),端粒酶阳性72例(87.8％)；82例食管癌手术切缘组织中COX-2阳性24例(29.3％),端粒酶阳性15例(18.3％),均高于正常食管上皮组织[5例(12.5％)和2例(5.0％)](均P＜ 0.05).COX-2和端粒酶在食管癌组织及手术切缘的表达与食管癌TNM分期、病理分化程度及淋巴结转移相关(均P＜0.05),在手术切缘的表达还与吻合口癌密切相关(P＜0.01).食管癌手术切缘中COX-2和端粒酶蛋白阳性表达患者术后生存率明显低于阴性表达患者(P=0.000)；在食管癌组织和手术切缘中,COX-2与端粒酶的表达均呈正相关(r=0.786、0.218,均P＜0.05).结论 COX-2和端粒酶在食管癌发生、侵袭和转移中起重要作用；COX-2和端粒酶在手术切缘的活性可作为早期预测吻合口复发的依据,并可作为评价手术效果和预后的指标.
목적 탐토배양합매2(COX-2)화단립매재식관암조직화수술절연중적표체급기림상의의,분석기재식관암중적진단화예후개치.방법 응용조직심편기술화면역조직화학EnVision법검측82례식관암환자종류표본급수술절연조직화40례정상식관상피조직(NEET)중COX-2화단립매적표체정황,병분석기여림상병리제인소지간급예후적관계.결과 82례식관암조직중COX-2양성68례(82.9％),단립매양성72례(87.8％)；82례식관암수술절연조직중COX-2양성24례(29.3％),단립매양성15례(18.3％),균고우정상식관상피조직[5례(12.5％)화2례(5.0％)](균P＜ 0.05).COX-2화단립매재식관암조직급수술절연적표체여식관암TNM분기、병리분화정도급림파결전이상관(균P＜0.05),재수술절연적표체환여문합구암밀절상관(P＜0.01).식관암수술절연중COX-2화단립매단백양성표체환자술후생존솔명현저우음성표체환자(P=0.000)；재식관암조직화수술절연중,COX-2여단립매적표체균정정상관(r=0.786、0.218,균P＜0.05).결론 COX-2화단립매재식관암발생、침습화전이중기중요작용；COX-2화단립매재수술절연적활성가작위조기예측문합구복발적의거,병가작위평개수술효과화예후적지표.
Objective To investigate the expression and clinical significance of COX-2 and telomerase activity in esophageal carcinoma tissues(ECT)and resection margin of the esophagus(RME),and to analyze their diagnostic and prognostic value for esophageal carcinoma.Methods The expression of COX-2 and telomerase activity in ECT and RME was examined in 82 patients with esophageal carcinoma and 40 normal esophageal epithelium tissues(NEET) by tissue array with EnVision imimunohistochemistry.Their correlations with the clinicopathologic factors were analyzed statistically.Results The positive expression rates of COX-2 and telomerase in ECT and RME were significantly higher than those in NEET(82.9 ％,29.3 ％vs 12.5 ％;and 87.8 ％,18.3 ％vs 5.0 ％;respectively;all P ＜ 0.05).The expression of COX-2 and telomerase in ECT and RME was correlated to TNM stage,tumor cell differentiation and lymph node metastasis (all P ＜0.01),while both expression in RME was closely related to anastomotic recurrence following resection of esophageal carcinoma (P＜0.01).The survival rate in esophageal carcinoma patients with the positive expression of COX-2 and telomerase in RME could be much lower than those with negative expression of COX-2 and telomerase in RME (P=0.000,Log-rank test).COX-2 expression was positively correlated to telomerase in ECT and RME (r=0.786,0.218,P＜0.05).Conclusion COX-2 and telomerase might be important biological markers for malignant transformation and invasion and metastasis of esophageal carcinoma.The activity of COX-2 and telomerase in RME could prognosticate anastomotic recurrence,and could be potential biomarkers evaluate the surgical treatment and prognosis of esophageal carcinoma.