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目的:探讨环氧合酶-2(COX-2)及Fas蛋白的表达与宫颈癌放疗敏感性的关系。方法:60例患者随机分成2组,单纯放疗(Radiotherapy,RT)组30例给予10Gy放疗,放化疗(Synchronal radiochemotherapy,CRT)组30例先行一次化疗后再给予10Gy放疗,采用免疫组织化学法分别检测30例单纯放疗和30例放化疗联合治疗宫颈癌患者治疗前后肿瘤细胞中COX-2及Fas蛋白的表达情况。结果:RT组和CRT组完全缓解率分别为50%和90%。Fas蛋白的表达在RT组治疗前后分别为33.33%和70.00%;在CRT组治疗前后分别为26.67%和76.67%,两组治疗前后比较均有显著性差异(P<0.01),阳性率组间比较均无显著性差异(P>0.05)。COX-2蛋白的表达在RT组治疗前后分别为50.00%和30.00%;在CRT组治疗前后分别为53.33%和23.33%,表达阳性率治疗后较治疗前明显降低,但RT组治疗前后阳性率比较无显著性差异(P>0.05),而CRT组治疗前后阳性率有显著性差异(P<0.05),治疗前后组间阳性率比较均无显著性差异(P>0.05)。经相关分析表明肿瘤细胞治疗前后Fas蛋白与COX-2表达均具有显著的等级负相关性。结论:COX-2可能通过下调或抑制Fas蛋白表达,从而促使肿瘤细胞逃避Fas系统介导的宿主免疫检测;放疗及化疗可下调COX-2的表达,两者结合检测治疗前后Fas和COX-2蛋白的表达,可作为较好的放疗敏感性的预测指标。
Objective: To investigate the relationship between the expression of cyclooxygenase-2 (COX-2) and Fas protein and the radiosensitivity of cervical cancer. Methods: Sixty patients were randomly divided into two groups. Radiotherapy (RT) group was given 30G radiotherapy for 10 Gy. Synchronized radiochemotherapy (CRT) group was given 30 Gy radiotherapy after 10 Gy radiotherapy. Immunohistochemistry The expression of COX-2 and Fas protein in tumor cells before and after treatment of 30 patients with cervical cancer treated with 30 radiotherapy alone and 30 patients with radiotherapy and chemotherapy were detected. Results: The complete remission rates of RT group and CRT group were 50% and 90% respectively. The expression of Fas protein was 33.33% and 70.00% respectively before and after treatment in RT group, and 26.67% and 76.67% before and after treatment in CRT group. There was significant difference between the two groups before and after treatment (P <0.01) There was no significant difference (P> 0.05). The expression of COX-2 protein was 50.00% and 30.00% before and after treatment in RT group, 53.33% and 23.33% in CRT group before and after treatment, respectively. The positive expression rate of COX-2 protein was significantly lower than that before treatment in RT group There was no significant difference between the two groups (P> 0.05). The positive rate of CRT before and after treatment was significantly different (P <0.05). There was no significant difference between the two groups before and after treatment (P> 0.05). Correlation analysis showed that there was a significant negative correlation between Fas protein and COX-2 expression before and after tumor cell therapy. Conclusion: COX-2 may induce tumor cells to escape Fas-mediated host immune detection by down-regulating or inhibiting the expression of Fas protein. The expression of COX-2 may be down-regulated by radiotherapy and chemotherapy. The combination of Fas and COX-2 Protein expression, can be used as a good predictor of radiosensitivity.