【摘要】 目的:探讨环氧化酶-2(COX-2)在直肠癌中的表达及其与直肠癌新辅助放疗敏感性的关系。方法:2013年1月至2016年1月收治并获得随访的直肠癌术前放射治疗的患者102例,免疫组织化学方法检测标本中的COX-2表达,分析其肿瘤及癌旁组织中COX-2的表达水平与放疗敏感性和患者预后的关系。结果:放疗敏感的患者为71例,放疗抵抗患者31例,放疗的敏感率为69.6%,肿瘤组织的COX-2表达显著高于癌旁组织(P<0.05),放疗敏感组阳性和强阳性的比例显著低于放疗抵抗组(P<0.05),且放疗抵抗组癌旁组织COX-2表达阳性的比例显著高于放疗敏感组(P<0.05),肿瘤COX-2阳性或强阳性(OR:4.21,95%CI:1.26~7.17)、癌旁组织COX-2阳性(OR:8.15,95%CI:1.43~38.21)为新辅助放疗抵抗的风险因素,生存分析显示,肿瘤组织COX-2表达阴性或弱阳性的患者生存期明显延长。结论:直肠癌患者中COX-2的表达与新辅助的放疗敏感性及预后具有显著的相关性,检测活检直肠癌肿瘤和癌旁组织中COX-2表达,有可能筛选对放化疗敏感的患者,使其获得更好的预后。更多还原

【Abstract】 Objective To study the expression of cyclooxygenase-2(COX-2)in colorectal cancer,and itsrelationship with the sensitivity of rectal cancer neoadjuvant radiotherapy. Methods 102 rectal cancer patientswith preoperative radiotherapy were selected from January 2013 to January 2016. The COX-2 expression of sampleswere detected by immunohistochemical. We analyzed the relationship of tumor and adjacent to carcinoma tissueCOX-2 expression,radiation sensitivity and the prognosis of patients. Results 71 cases with radiation sensitivityand 31 radiation resistance cases,radiation sensitive rate was 69.6%. The COX-2 expression in the tumor tissuewas significantly higher than adjacent tissue(P < 0.05),radiation sensitive patient proportion with positive andstrong positive COX-2 expression was significantly lower than the radiation resistance(P < 0.05). The adjacent tocarcinoma tissues COX-2 positive expression of radiation resistance group proportion was significantly higher thanthe radiation sensitive group(P < 0.05). The tumor COX-2 positive OR strongly positive(OR:4.21,95% CI:1.26-7.17),tissue adjacent to carcinoma COX-2 positive(OR:8.15,95% CI:1.43-38.21)were risk factors forneoadjuvant radiotherapy resistance. The survival analysis showed that tumor tissue COX-2 expression of negativeOR weakly positive patients survival significantly extended. Conclusions There were significant correlations be-tween the expression of COX-2,neoadjuvant radiotherapy sensitivity and prognosis in colorectal cancer patients.the joint detection biopsy COX-2 expression in colorectal cancer patients with tumor and cancer adjacent tissues,may screening out patients sensitive to radiation and chemotherapy,which making patient better prognosis.更多还原