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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)。Ka-plan-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。
Objective This study aimed to investigate the expression of NICD and COX-2 in gastric cancer and its clinical significance. Methods The expression of NICD and COX-2 in 109 cases of gastric cancer, 57 cases of gastric precancerous lesions and 72 cases of chronic superficial gastritis were detected by immunohistochemistry. The relationship between the expression of NICD and COX-2 was analyzed. The relationship between the people. Results The positive rate of NICD in gastric cancer group was 74.31% (81/109), which was significantly higher than that in precancerous lesions group (31.58%, 18/57) and chronic superficial gastritis group (23.61%, 17/72) (χ2 = 53.45 , P <0.01), which was related to tumor size, differentiation degree, depth of invasion and lymph node metastasis (χ2 = 5.51, P <0.05; χ2 = 4.76, P < 0.05). The positive rate of COX-2 in gastric cancer was 71.56% (78/109), which was significantly higher than that in precancerous lesions (1.75%, 1/57) and chronic superficial gastritis (0.00%, 0/72) (χ2 = 133.50, P <0.01), which was related to the degree of tumor differentiation and lymph node metastasis (χ2 = 20.78, P <0.01; χ2 = 4.15, P <0.05). There was a positive correlation between NICD and COX-2 expression in gastric cancer (r = 0.30, χ2 = 9.38, P <0.01). Ka-plan-Meier analysis showed that the 2-year survival rate was 50.50% in NICD positive group and 72.80% in negative group. The 2-year survival rate was 55.10% in COX-2 positive group and 71.40% in negative group. The NICD positive The 2-year survival rates of COX-2 positive group, NICD positive COX-2 negative group, NICD negative COX-2 positive group and NICD negative COX-2 negative group were 43.10%, 100.00%, 66.7% and 100.00% respectively. The log-rank test of survival curves showed that the positive rates of NICD and COX-2 in gastric cancer patients were statistically significant (χ2 = 9.70, P <0.01; χ2 = 7.95, P <0.01). Cox regression analysis showed that NICD and COX-2 were independent prognostic factors (χ2 = 7.55, P <0.05; χ2 = 4.45, P <0.05). Conclusions NICD and COX-2 may play a role in carcinogenesis and progression of gastric cancer. The expression level of these two indexes may be used as an index to evaluate the prognosis of gastric cancer. The combined detection of these two indexes has some clinical significance in the prognosis of gastric cancer value.