环氧合酶-2在血吸虫病大肠癌患者肠组织中的表达及其预后的关系

发布时间：2019-01-10 16:12

【摘要】：背景:大肠癌是世界范围内,特别是亚洲地区的常见恶性肿瘤之一,其发病机制及诱发因素目前没有明确的说法。近来一些研究显示,环氧合酶-2(Cyclooxygenase 2,COX-2)在多数大肠癌组织及细胞系中表达增高,它可能促进大肠癌的侵袭转移及血管组织的生成,并且与大肠癌的高复发率及低生存率紧密相关。研究证实抑制COX-2的活性可以抑制大肠癌的血管组织的生长,从而抑制大肠癌细胞的增殖,同时使其凋亡增加,使体内成瘤的概率减小,前列腺素的合成同时受到抑制。这些都提示COX-2与大肠癌的发生发展有着密切的关系。近期关于血吸虫病研究发现,血吸虫病大肠癌患者COX-2的活性表达明显升高,关于COX-2的表达对血吸虫直肠癌患者的预后尚未有明确的实验报道,本研究主要研究COX-2在血吸虫病合并大肠癌中的表达情况,从而为血吸虫病是否影响大肠癌的预后提供一定的实验基础和理论依据。目的:研究分析环氧合酶-2在血吸虫病大肠癌患者肠组织中的表达及其预后的关系,为临床诊断及预后的评估提供指导。方法:由2013年6月-2015年12月间手术病理标本室中按照血吸虫病大肠癌肿瘤组织、非血吸虫病大肠癌肿瘤组织及正常肠组织的分组各提取病理标本60例,作为研究对象,分别记作A、B、C组。采用链霉素抗生物素蛋白-过氧化酶连接(SP)和免疫组织化学方法对研究对象的环氧合酶-2予以检测,并对其在各组织中的表达情况进行组间比较。根据检查结果将血吸虫病大肠癌肿瘤组织分为环氧合酶-2阳性组和阴性组,并对性别、年龄、肿瘤大小、分化程度、Dukes分期及淋巴转移情况进行组间比较。根据随访1年的转归情况对血吸虫病大肠癌肿瘤组织标本予以分组,分为好转组和恶化组,并比较两组的环氧合酶-2表达情况。结果:按照标本结果判定方法及评价标准分别对三组研究标本进行评价,其阳性率分别为76.6%,58.3%和3.33%,A、B、C组的环氧合酶-2阳性率依次降低,组间均存在显著性差异(P0.05);按环氧合酶-2表达分组性别、年龄、肿瘤大小及肿瘤部位等数据组间无显著差异(P0.05);而分化程度低、Dukes分期晚及淋巴结转移情况等阳性率显著高于分化程度高、Dukes分期早及无淋巴结转移组(P0.05);血吸虫合并直肠癌患者1年复发率(53.3%)明显高于非血吸虫直肠癌患者(33.3%),且存在显著差异性(P0.05)。结论:环氧合酶-2在血吸虫病大肠癌患者肠组织中的表达的阳性率显著高于非血吸虫大肠癌患者肠组织及正常肠组织,其预后复发率显著高于非血吸虫大肠癌患者,分化程度低、Dukes分期晚及淋巴结转移情况等阳性率显著高于分化程度高、Dukes分期早及无淋巴结转移组,因此环氧合酶-2表达对血吸虫病大肠癌的诊断、病情评估及预后预测具有重要的价值。
[Abstract]:Background: colorectal cancer is one of the most common malignant tumors in the world, especially in Asia. Recent studies have shown that the expression of cyclooxygenase-2 (Cyclooxygenase _ 2) is increased in most colorectal cancer tissues and cell lines, which may promote invasion, metastasis and angiogenesis of colorectal cancer. It is closely related to the high recurrence rate and low survival rate of colorectal cancer. It has been proved that inhibiting the activity of COX-2 can inhibit the growth of vascular tissue of colorectal cancer, thus inhibit the proliferation of colorectal cancer cells, increase its apoptosis, reduce the probability of tumorigenesis in vivo, and inhibit the synthesis of prostaglandins at the same time. All these suggest that COX-2 is closely related to the occurrence and development of colorectal cancer. Recent studies on schistosomiasis have found that the expression of COX-2 activity in patients with colorectal cancer of schistosomiasis is significantly increased, and there is no clear experimental report on the expression of COX-2 for the prognosis of patients with schistosomiasis rectal cancer. The purpose of this study was to study the expression of COX-2 in schistosomiasis complicated with colorectal cancer, and to provide experimental and theoretical basis for whether schistosomiasis affects the prognosis of colorectal cancer. Objective: to study the expression and prognosis of cyclooxygenase-2 in colorectal cancer patients with schistosomiasis and to provide guidance for clinical diagnosis and prognosis evaluation. Methods: from June 2013 to December 2015, 60 specimens were collected from surgical and pathological specimens from colorectal cancer tissues of schistosomiasis, non-schistosomiasis colorectal cancer tissues and normal intestinal tissues, respectively. They were recorded as group A, B, C, respectively. Streptomycin biotin-peroxidase (SP) and immunohistochemical method were used to detect cyclooxygenase-2 and to compare the expression of cyclooxygenase-2 in different tissues. According to the examination results, the tumor tissues of colorectal cancer of schistosomiasis were divided into two groups: positive group and negative group. Sex, age, tumor size, differentiation degree, Dukes stage and lymphatic metastasis were compared among groups. According to the result of follow-up for one year, the tumor specimens of colorectal cancer of schistosomiasis were divided into two groups: the improvement group and the worsening group, and the expression of cyclooxygenase-2 was compared between the two groups. Results: the positive rates of cyclooxygenase-2 in the three groups were 76.6%, 58.3% and 3.33%, respectively, and the positive rates of cyclooxygenase-2 were decreased in turn. There was significant difference between the two groups (P0.05). There was no significant difference in sex, age, tumor size and tumor location between the two groups according to the expression of cyclooxygenase-2 (P0.05). The positive rate of Dukes staging and lymph node metastasis was significantly higher than that of high differentiation degree. The positive rate of Dukes early stage and no lymph node metastasis group was significantly higher than that of Dukes stage group (P0.05). The one-year recurrence rate in patients with schistosomiasis complicated with rectal cancer (53.3%) was significantly higher than that in patients with non-schistosomiasis rectal cancer (33.3%), and there was significant difference (P0.05). Conclusion: the positive rate of cyclooxygenase-2 expression in intestinal tissues of colorectal cancer patients with schistosomiasis is significantly higher than that in intestinal tissues and normal intestinal tissues of patients with non-schistosomiasis colorectal cancer, and the recurrence rate of cyclooxygenase-2 is significantly higher than that of colorectal cancer patients with non-schistosomiasis colorectal cancer. The positive rates of Dukes stage late and lymph node metastasis were significantly higher than those of high differentiation degree Dukes stage and no lymph node metastasis. Therefore the expression of cyclooxygenase-2 was used in the diagnosis of schistosomiasis colorectal cancer. The evaluation and prognosis of the disease are of great value.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34;R532.21

【参考文献】