目的研究环氧合酶(COX)-2和尿激酶型纤溶酶原激活物(uPA)在胃癌中的表达,分析其与临床病理特征及生存期的关系。方法用组织芯片技术和免疫组化法检测甘肃省武威地区192例胃癌组织、56例癌旁组织中COX-2、uPA的表达,免疫组化双染测微血管密度(MVD)和微淋巴管密度(MLD)。取30例当地同期胃镜检查的正常胃黏膜标本作为对照。结果COX-2在胃癌和癌旁组的阳性率(67。7%和62.5%)均显著高于对照组(40%,P〈0.05),且与浸润深度和MVD有关(均P〈0.05)。uPA在胃癌、癌旁和对照组各组阳性率比较,差异均有统计学意义(78.1%、44.6%、6.7%,均P〈0.01),且与淋巴结转移、浸润深度、Lauren分型、分化程度、MLD、MVD有关(P〈0.05或〈0.01)。COX-2和uPA表达呈正相关(r=0.167,P=0.021)。uPA阳性组平均生存期显著低于阴性组[(38±4)个月vs(54±6)个月,P〈0.05],COX-2和uPA双阳性组平均生存期显著低于单阳性组和双阴性组[(27±3)个月VS(58±4)个月,P〈0.01]。结论胃癌中COX-2与uPA高表达,二者的表达呈正相关;COX-2和uPA参与胃癌发生发展的早期过程,uPA的表达与生存期密切相关。
Objective To investigate expression of cyclooxygenase-2 (COX-2) and urokinase plasminogen activator (uPA) in gastric carcinoma and the clinical significance thereof. Methods Strepavidin-peroxidase method was used to detect the expression of COX-2 and uPA in 192 specimens of gastric carcinoma, 56 specimens of paracancer tissues obtained during operation. Immunohistochemical double staining was used to detect the microvessel density (MVD) and microlymphatie density (MLD). Thirty specimens of normal gastric mucosa obtained during gastroscopy were used as controls. Results The positive rates of COX-2 in the gastric carcinoma and paraeancer tissues were 67. 7% and 62. 5% respectively, both significantly higher than that of the control group (40.0%, both P 〈0.05 ). The positive expression of COX-2 in gastric carcinoma was significantly related with the depth of invasion and MVD ( both P 〈 0.05 ). The positive rates of uPA in the gastric carcinoma, paraeancer tissue were 78.1% and 44.6% respectively, both significantly higher than that of the control tissues (6.7% , both P 〈0.01 ) and there was a significant difference in the positive rates of uPA between the first 2 groups too (P 〈0.01 ). The positive expression of uPA in gastric carcinoma was significantly related with lymph node metastasis, depth of invasion, Lauren typing, differentiation, MVD, and MLD (P 〈0.05, P 〈0.01 ). COX-2 expression was positively linked with uPA expression (r = 0. 167, P =0.021 ). The survival time of the uPA positive group was (38 ±4) months, significantly shorter than that of the negative group [ ( 54 ±6 ) months, P 〈 0.05 ]. The survival time of the group positive in both COX-2 and uPA was (27 ± 3 ) months, significantly shorter than that of the single positive or double negative groups [ both ( 58 ± 4 ) months, both P 〈 0. 01 ). Conclusion COX-2 and uPA are highly expressed in gastric carcinoma. COX-2 expression is positively linked with uPA expression. COX-2 a