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環(huán)氧合酶-2在血吸蟲病大腸癌患者腸組織中的表達及其預(yù)后的關(guān)系

發(fā)布時間:2019-01-10 16:12
【摘要】:背景:大腸癌是世界范圍內(nèi),特別是亞洲地區(qū)的常見惡性腫瘤之一,其發(fā)病機制及誘發(fā)因素目前沒有明確的說法。近來一些研究顯示,環(huán)氧合酶-2(Cyclooxygenase 2,COX-2)在多數(shù)大腸癌組織及細胞系中表達增高,它可能促進大腸癌的侵襲轉(zhuǎn)移及血管組織的生成,并且與大腸癌的高復(fù)發(fā)率及低生存率緊密相關(guān)。研究證實抑制COX-2的活性可以抑制大腸癌的血管組織的生長,從而抑制大腸癌細胞的增殖,同時使其凋亡增加,使體內(nèi)成瘤的概率減小,前列腺素的合成同時受到抑制。這些都提示COX-2與大腸癌的發(fā)生發(fā)展有著密切的關(guān)系。近期關(guān)于血吸蟲病研究發(fā)現(xiàn),血吸蟲病大腸癌患者COX-2的活性表達明顯升高,關(guān)于COX-2的表達對血吸蟲直腸癌患者的預(yù)后尚未有明確的實驗報道,本研究主要研究COX-2在血吸蟲病合并大腸癌中的表達情況,從而為血吸蟲病是否影響大腸癌的預(yù)后提供一定的實驗基礎(chǔ)和理論依據(jù)。目的:研究分析環(huán)氧合酶-2在血吸蟲病大腸癌患者腸組織中的表達及其預(yù)后的關(guān)系,為臨床診斷及預(yù)后的評估提供指導(dǎo)。方法:由2013年6月-2015年12月間手術(shù)病理標(biāo)本室中按照血吸蟲病大腸癌腫瘤組織、非血吸蟲病大腸癌腫瘤組織及正常腸組織的分組各提取病理標(biāo)本60例,作為研究對象,分別記作A、B、C組。采用鏈霉素抗生物素蛋白-過氧化酶連接(SP)和免疫組織化學(xué)方法對研究對象的環(huán)氧合酶-2予以檢測,并對其在各組織中的表達情況進行組間比較。根據(jù)檢查結(jié)果將血吸蟲病大腸癌腫瘤組織分為環(huán)氧合酶-2陽性組和陰性組,并對性別、年齡、腫瘤大小、分化程度、Dukes分期及淋巴轉(zhuǎn)移情況進行組間比較。根據(jù)隨訪1年的轉(zhuǎn)歸情況對血吸蟲病大腸癌腫瘤組織標(biāo)本予以分組,分為好轉(zhuǎn)組和惡化組,并比較兩組的環(huán)氧合酶-2表達情況。結(jié)果:按照標(biāo)本結(jié)果判定方法及評價標(biāo)準(zhǔn)分別對三組研究標(biāo)本進行評價,其陽性率分別為76.6%,58.3%和3.33%,A、B、C組的環(huán)氧合酶-2陽性率依次降低,組間均存在顯著性差異(P0.05);按環(huán)氧合酶-2表達分組性別、年齡、腫瘤大小及腫瘤部位等數(shù)據(jù)組間無顯著差異(P0.05);而分化程度低、Dukes分期晚及淋巴結(jié)轉(zhuǎn)移情況等陽性率顯著高于分化程度高、Dukes分期早及無淋巴結(jié)轉(zhuǎn)移組(P0.05);血吸蟲合并直腸癌患者1年復(fù)發(fā)率(53.3%)明顯高于非血吸蟲直腸癌患者(33.3%),且存在顯著差異性(P0.05)。結(jié)論:環(huán)氧合酶-2在血吸蟲病大腸癌患者腸組織中的表達的陽性率顯著高于非血吸蟲大腸癌患者腸組織及正常腸組織,其預(yù)后復(fù)發(fā)率顯著高于非血吸蟲大腸癌患者,分化程度低、Dukes分期晚及淋巴結(jié)轉(zhuǎn)移情況等陽性率顯著高于分化程度高、Dukes分期早及無淋巴結(jié)轉(zhuǎn)移組,因此環(huán)氧合酶-2表達對血吸蟲病大腸癌的診斷、病情評估及預(yù)后預(yù)測具有重要的價值。
[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.
【學(xué)位授予單位】:南昌大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2017
【分類號】:R735.34;R532.21

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