非小细胞肺癌中EGFR、VEGF和COX-2表达的预后意义  

Prognostic value of EGFR、VEGF and COX-2 expression in patients with non-small cell lung cancer

作　　者：胡雪君[1] 宋娜[1] 刘云鹏[1] 马艳菊[1] 郝艳艳[1] 康健[1] 

机构地区：[1]中国医科大学附属第一医院,辽宁沈阳110001

出　　处：《现代肿瘤医学》2007年第6期772-775,共4页Journal of Modern Oncology

基　　金：辽宁省科技攻关计划(2004225004-11;2005225013-7)

摘　　要：目的:探讨EGFR、VEGF和COX-2这三种与肿瘤血管生成相关的蛋白在非小细胞肺癌(NSCLC)中的表达与临床病理特征和预后的关系。方法:将88例NSCLC及10例正常肺组织标本制作成组织芯片,应用免疫组化S-P法检测EGFR、VEGF和COX-2的表达,并与临床病理特征及预后进行比较分析。结果:EG-FR、VEGF和COX-2在NSCLC标本中的阳性表达率分别为46.6%、67.0%和71.6%,而三者在10例正常肺组织中表达均为阴性。EGFR表达与各种临床病理参数均无关(P>0.05),VEGF在女性病人中表达升高(P=0.035),COX-2在女性、不吸烟者、腺癌和淋巴结转移阳性者中表达升高(P值分别为0.005,0.027,0.001和0.003)。EGFR和VEGF、VEGF和COX-2之间呈正相关关系(γ=0.267,P=0.012和γ=0.416,P=0.000),而EGFR和COX-2之间无相关性(P=0.441)。生存分析显示EGFR和VEGF表达与生存期无关(P=0.110和P=0.773),而COX-2阳性表达者生存期短(P=0.014)。多因素分析显示EGFR、VEGF和COX-2表达不是影响预后的独立危险因素。结论:EGFR、VEGF和COX-2在NSCLC中表达升高且存在正相关关系,可能在肿瘤血管形成过程中起协同作用。COX-2阳性表达者生存期短,可能在预后判定中有重要作用。Objective： To evaluate the relationship between expression of EGFR, VEGF and COX -2, and the relationship between expression and clinicopathologic parameters and survival in patients with non - small cell lung cancer （NSCLC）. Methods： Expressions of EGFR, VEGF and COX - 2 were accessed by immunohistochemical staining on tissue microarray sections made of 88 cases of NSCLC and 10 cases of normal lung samples. The results were compared with relevant clinical and pathologic data. All cases were followed up for more than 5 years. Results： Positive rates of EGFR, VEGF and COX -2 were 46.6%, 67.0% and 71.6%, respectively. None of normal lung samples was expressed. There was no correlation between EGFR expression and any clinical characteristics （P 〉 0.05 ）. Positive expression of VEGF was higher in female patients （P = 0. 035 ）. Positive expression of COX - 2 was significandy higher in groups of female, non - smokers, adenocarcinoma and lymph node metastasis （P 〈 0.05 ）. A positive correlation was found between expression of EGFR and VEGF, VEGF and COX -2 （γ = 0. 198, P = 0.02 and γ= 0.416, P = 0.000）. Patients with positive expression of COX - 2 had worse survival （P = 0.014 ）. Multivariate analysis using Cox regression modal showed that none of the biomarkers was the important independent prognostic factor for survival. Conclusion： EGFR, VEGF and COX -2 are aberrant highly expressed in NSCLC with positive correlation, which indicate they might act synergistically in angiogenesis of NSCLC. Aberrant expression of COX - 2 is related with shorter survival and COX -2 may be useful as an indicator for prognosis in NSCLC.

关 键 词：肺肿瘤 表皮生长因子受体 血管内皮生长因子 环氧合酶-2 免疫组织化学 

分 类 号：R734.2[医药卫生—肿瘤]