【作者】 杨立；

【导师】 王力红；

【作者基本信息】 四川大学 ， 耳鼻咽喉科学， 2007， 硕士

【摘要】 目的：探讨环氧化酶-2（COX-2）和基质金属蛋白酶-7（MMP-7）在喉鳞状细胞癌组织中的表达及其与肿瘤发生、浸袭转移及预后的关系。方法：用免疫组化SP法检测定65例喉鳞癌肿瘤组织及34例癌旁组织中COX-2和MMP-7的表达，并分析两者的表达水平与各临床病理参数（年龄、病程、吸烟、饮酒、TN分期、病理分级、无瘤总生存时间、总生存时间）的关系。结果用SPSS 10．0统计软件进行分析。结果：COX-2和MMP-7在肿瘤组织中的阳性表达率分别为70．8％和75．4％，与对照癌旁非肿瘤组织比较（20．5％，23．5％），其表达显著增高，差别均有统计学意义（P＜0．01），且COX-2和MMP-7的表达呈正相关（P＜0．01）。T_3-4期喉癌组织中COX-2的表达水平显著高于T_1-2期（P＜0．01），临床3、4期喉癌组织中COX-2的表达水平显著高于临床1、2期（P＜0．01）。COX-2和MMP-7表达水平随肿瘤临床分期的进展显著增高（P＜O．05，P＜O．05）。COX-2和MMP-7的表达与年龄、病程、吸烟、饮酒、N分期、病理分级、临床分型均无明显关系（P＞0．05）。COX-2阳性表达组总生存期和无瘤生存期较COX-2阴性表达组明显缩短，差异有显著性（P＜0．05，P＜0．05），但经COX多因素分析不是喉癌复发及死亡的独立危险因素。MMP-7阳性和阴性表达组之间生存期和无瘤生存期无明显差异（P＞0．05）。结论：喉癌组织中存在着COX-2和MMP-7的过度表达，其促进了喉鳞癌的发生和侵袭，且两者在肿瘤的发生和进展过程中可能存在协同作用，COX-2的过度表达提示预后不良。COX-2和MMP-7是喉癌治疗的新靶点。更多还原

【Abstract】 Objective:To evaluate the expression of COX-2, MMP-7 in laryng- eal carcionma and to explore the role in the invasion, metastasis and prognosis of laryngeal carcinoma.Methods: The expression of COX-2,MMP-7 in 65 primary laryngeal carcinoma tissues and 34 adjacent non-neoplastic tissues were studied by immunohistochemical SP method. Age,duration,smoking, alcohol consuming, TN staging, differentiation,clinical typing, disease free survival and survival were also recorded, and their relations to the expression of COX-2, MMP-7 were analyzed by SPSS10.0.RESULTS: The expression of COX-2 and MMP-7 was observed in 70.8%,75.4% of the cases at the primary site and in 20.5%,23.5% of the adjacent non-neoplastic tissues,which had a significant difference （P＜0.01）. In addition,there was a significant positive correlation between the expression of COX-2 and MMP-7 （P＜0.01）. The expression of COX-2 in clinical T_3-4 stages laryngeal carcinoma was obviously higher than that in T_1-2 stages（P＜0.01）. The expression of COX-2 and MMP-7 was positively correleted with the advancement of clinic staging（P＜0.05）.While,no significant correlation was found between the expression of COX-2 and MMP-7 with other variables—Age,duration,smoking, alcohol consuming, N staging, differentiation,clinical typing.The expression of COX-2 displayed a significant decrease in disease free survival and survival, but it was not an independent risk factor through COX regression. There was no significant difference in disease free survival and survival between MMP-7 positive group and negative group.Conclusion: The overexpression of COX-2 and MMP-7 was observed in laryngeal carcinoma tissues,which might play an crucial role in the oncogenesis and invasion of laryngeal carcinoma.There might be a synergistic effect in the process of tumor development .The overexpression of COX-2 predict a poor prognosis. Both COX-2 and MMP-7 is hoped to become the new treated target of laryngeal carcinoma.更多还原