Prognostic factors and COX-2 expression in advanced stage esophageal squamous cell carcinoma
Prognostic factors and COX-2 expression in advanced stage esophageal squamous cell carcinoma
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DOI：
10.1007/bf02850306
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发表时间：
2006-09-01
影响因子：
3.8
通讯作者：
Izmirli, Mustafa
中科院分区：
文献类型：
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作者：
Alici, Suleyman;Ugras, Serdar;Izmirli, Mustafa
环氧合酶-2(COX-2)在包括食管鳞癌在内的多种人类恶性肿瘤中均有过表达，但其在食管鳞癌(ESCC)中的临床病理作用尚不清楚。本研究的目的是分析COX-2在ESCC中的表达及其与临床病理参数和生存期的关系。从1999年到2003年，收集了110例食管鳞癌患者的内窥镜组织样本进行分析。免疫组织化学染色检测COX-2的表达。对临床病理资料进行分析，以验证其意义。在110例食管癌组织中，50例(45%)表达COX-2。COX-2在73%的肿瘤中低表达到弱表达，在27%的肿瘤中强表达(高表达)。根据临床分期(IVM1a/IVM1b)：癌抗原(CA)19-9(正常/高)(P=0.011)、CA12-5(正常/高)(P=0.011)、CA15-3(正常/高)(P=0.035)，COX-2高表达与COX-2低表达有统计学差异(P=.001)。COX-2高表达患者的生存率(中位总生存期3个月)显著低于COX-2低表达组(中位总生存期6个月)(P=0.0001)。单因素分析显示，年龄、体重指数、分期、COX-2、乳酸脱氢酶、CA12-5、CA15-3是影响预后的重要因素。经Cox回归分析，只有分期(P=.000)、COX-2(P=.000)、乳酸脱氢酶(P=.023)和CA15-3(P=.002)是独立的预后因素。结果表明，在ESCC患者中，COX-2的过度表达与内脏转移(IVM1b)显著相关。COX-2过度表达是ESCC预后不良的因素。
Cyclooxygenase-2 (COX-2) is overexpressed in various types of human malignancies, including squamous cell carcinomas of the esophagus, but its clinicopathologic role in esophageal squamous cell carcinoma (ESCC) remains unclear. The aim of this study was to analyze expression of COX-2 in ESCC and to correlate this expression with clinicopathologic parameters and survival. From 1999 to 2003, endoscopic tissue samples from 110 patients with ESCC were collected for analysis. COX-2 expression was examined through immunohistochemical staining. Clinicopathologic data were analyzed to verify significance. COX-2 expression was detected in 50 of 110 ESCC specimens (45%). COX-2 expression was negative to weak in 73% (COX-2 low) and moderate to strong in 27% (COX-2 high) of tumors. Statistical differences between COX-2 high and COX-2 low were found according to status of the stage (stage IVM1a/IVM1b) (P=.001): cancer antigen (CA) 19-9 (normal/high) (P=.011), CA 12-5 (normal/high) (P=.011), and CA 15-3 (normal/high) (P=.035). Survival was significantly reduced among patients with high COX-2 expression (median overall survival, 3 mo) when compared with the COX-2 low group (median overall survival, 6 mo) (P=.0001). In the univariate analysis, age, body mass index, stage, COX-2, lactate dehydrogenase, CA 12-5, and CA 15-3 were significant factors for survival. With the use of COX regression analysis, only stage (P=.000), COX-2 (P=.000), lactate dehydrogenase (P=.023), and CA 15-3 (P=.002) were independent prognostic factors. Results showed that in patients with ESCC, COX-2 overexpression was significantly correlated with visceral metastases (IVM1b). COX-2 overexpression is an unfavorable prognostic factor in ESCC.