【作者】 薛群；

【导师】 沈振亚； 章臣楠；

【作者基本信息】 苏州大学 ， 心胸外科， 2002， 硕士

【摘要】 目的：研究血管内皮生长因子(VEGF)、环氧化酶-2(COX-2)在非小细胞肺癌(NSCLC)、癌旁组织、正常肺组织中的表达，探讨VEGF、COX-2在非小细胞肺癌的发生、发展中所起的作用及二者之间的相互关系。 方法：应用免疫组织化学法，检测60例非小细胞肺癌和癌旁组织及20例正常肺组织中VEGF、COX-2的表达。 结果：(1)NSCLC肺癌组织VEGF、COX-2表达显著高于癌周及正常肺组织(P＜0.001)。(2)VEGF在NSCLC肺癌中的表达与临床分期、肿瘤大小、淋巴结转移的关系密切(P＜0.01，P＜0.05，P＜0.01)，随着肿瘤分期期次的升高、肿瘤体积增大和淋巴结转移的增多，VEGF阳性表达率明显上升；与组织分化程度、组织学分型无关(P＞0.05，P＞0.05)。(3)COX-2在NSCLC肺癌中的表达与临床分期、肿瘤大小、淋巴结转移也存在显著关系(P＜0.001，P＜0.05，P＜0.05)，肿瘤分期越晚、肿瘤越大及淋巴结转移越多，COX-2阳性表达率越高；与组织分化程度、组织类型也有明显关系(P＜0.05，P＜0.001)，发现中高分化的肿瘤组织中COX-2的表达明显高于低分化的肿瘤组织；腺癌中COX-2的表达明显高于鳞癌。(4)VEGF和COX-2在共同参与NSCLC的发生、发展和淋巴结的转移过程中，存在明显的相关性，COX-2表达可上调VEGF的表达，而COX-2低表达者，VEGF的表达也下降。 结论：VEGF、COX-2在NSCLC组织中呈高表达，他们在NSCLC的发生和发展中起重要作用；VEGF、COX-2表达的增高可能预示NSCLC肿瘤生长较快、病程较晚、存在淋巴结的转移；而单独的COX-2高表达更多见于腺癌和分化较好的NSCLC；VEGF和COX-2存在密切的相关性，它们共同参与NSCLC的生长、侵袭和淋巴结转移，有益于判断NSCLC病变的发展、淋巴结转移及其预后，同时，为VEGF、COX-2抑制剂在预防和治疗NSCLC方面也提供了一定的理论基础。更多还原

【Abstract】 Objective:By detecting the expression of Vascular endothelial growth factor(VEGF) and cyclooxygenase-2(COX-2) in the tissue of non-small cell lung cancer(NSCLC).paracancerous and normal lung tissues.we studied the effects of VEGF and COX-2 and the correlation between VEGF and COX-2 on the development of NSCLC.Methods: The expression of VEGF and COX-2 were detected in 60 cases of NSCLC, the same cases of paracancer tissues of NSCLC and 20 cases of normal lung tissues by imnuinohistochemical method.The experimental data was analysed with Chi squane test.Results: (1 )The rate of positive expression of VEGF and COX-2 were higher in the tissues of NSCLC than those in paracancerous tissues of NSCLC and in normal lung tissues .It was significantly difference(P<0.001).(2) The degree of expression of VEGF in NSCLC was relative to clinical stages(P<0.01),the size of tumor(P<0.05).metastatic lymponode (PO.Ol).but was not relative to the histologic classes and pathological types.The later clinical stage,the bigger tumor and the more metastatic lymponode .the higher rate was the postive expression of VEGF. (3) The expression of COX-2 in NSCLC was associated with clinical stage.tumor size,pathological type.histologic class or metastatic lymponode (P<0.01, P<0.05, PO.001. PO.05. P<0.01).The later clinical stage, the bigger tumor and the more metastatic lymponode the higher rate was the positive expression of VEGF. The rate of expression of COX-2 in adenocarcinoma was significantly higher than that in squamous carcinoma. The rate of expression of COX-2 in the well differentiated NSCLC was significantly higher than that in the poorly differentiated NSCLC.(4)The level of VEGF was closely related to the level of COX-2 in the carcinoma of NSCLC.Conclusion: These experimental results were suggested that VEGF and COX-2play an important roles in oncogenesis and progression of NSCLC.The higher positive expression of VF.GF and COX-2 were indication for the tumor growing quickly and the desease stage being later.and lymponode having metastasis.The overexpression of COX-2 was always detected in adenocarcinoma and well differentiated carcinoma in NSCLC. The expression of VEGF was closely related to the expression of COX-2.VEGF had took part in the development.invasion of carcinoma and lymponode metastasis togather with COX-2 in NSCLC. Detection the level of VEGF and COX-2 expression might be useful to judge the stage of desease and lymponode metastasis of NSCLC.and to predict the prognosis of patients with NSCLC.Also, this result was provided a fundamental theory for selecting chemical agents of inhibiting VEGF and COX-2 from action in the prevention and treatment of NSCLC.更多还原