还氧合酶-2在乳腺良恶性病变中的表达及意义  

Significance of COX-2 expression in benign and malignant breast diseases

作　　者：姚建国[1] 陈莉[2] 包蕾[1] 

机构地区：[1]南通大学附属南通三院病理科,226006 [2]南通大学附属南通三院病理教研室,226006

出　　处：《国际肿瘤学杂志》2008年第7期556-559,共4页Journal of International Oncology

摘　　要：目的探讨环氧合酶2（COX-2）在乳腺良恶性病变中的表达和分布情况及COX-2表达与乳腺癌临床病理因素、激素受体等的关系。方法分别对8例副乳腺、31例乳腺良性增生性疾病（BPBD，包括腺病15例，纤维腺瘤16例）、70例浸润性导管癌（IDC），其中35例伴有导管原位癌（DCIS）标本进行COX-2免疫组化标记，观察COX-2在这些组织中的表达情况和分布特征并与C—erbB-2、雌激素受体（ER）、孕激素受体（PR）、临床病理因素等进行对比。结果①COX-2表达8例副乳腺全部阴性；BPBD阳性率为96．5％（30／31），其中腺病93．3％（14／15），纤维腺瘤100％（16／16）；DCIS阳性率为85．7％（30／35），表达强度≥相应癌组织；IDC阳性率为84．3％（59／70），癌周非癌腺体有不同程度的COX．2表达。②COX-2在BPBD的阳性率明显高于IDC，两者间差异有统计学意义（X^2=9．39，P〈0．025）；③cox-2阳性表达在DCIS中与组织分化低（X^2=10．98，P〈0．005）、PR阴性（P=0．019）及C-erbB-2阳性（P=0．0008）有关。在IDC中主要与淋巴结转移（X^2=4．09，P〈0．05）、组织分化低（P=0．004）、PR阴性（X^2=6．91，P〈0．01）及C-erbB-2阳性（X^2=5．94，P〈0．025）等有关。结论COX-2在正常乳腺组织不表达，在BPBD、DCIS和IDC中均有较高表达，提示COX-2表达上调既参与乳腺致癌，又促进其发展和转移，并可能参与了PR阴性乳腺癌对辅助性内分泌治疗的抵抗性而使治疗反应性下降。Objective To investigate the expression and distribution of COX-2 in benign and malignant breast disease, and the relationship among COX-2 expression and the clinicopathologic factors, hormone receptors. Methods Immunohistochemistry was used to investigate the expression and distribution of COX-2 in 8 accessory, breasts, 31 BPBDs （15 in adnosis, 16 in fibroadnoma） ,70 IDCs （35 of them accompany with DCIS ） ; The relationships between the expression of COX-2 and hormone receptor （ER and PR） , C-erbB-2, and the clinicopathologic factors were studied respectively. Results ①The expression of COX-2 in various kinds mammary diseases： 8 accessory breasts were all negative; the positive rate of COX-2 in BPBD was 96. 5% （30/31） , among these, the positive rate of COX-2 in adnosis was 93.3% （14/15）, and in fibroadnoma was 100% （16/16）. The positive rate of COX-2 in DCIS was 85.7% （30/35）. The intensity of COX-2 expression in DCIS of periph- IDC was higher than that in corresponding carcinoma. The positive rate of COX-2 in IDC was 84. 3% （59/70）, the expression of COX-2 was different among non-cancer gland. ②COX-2 expression in BPBD was obviously higher compared with COX-2 in IDC, the difference was significant in statistics （X^2 = 9. 39, P 〈 0. 025 ）, ③The expression of COX-2 in DCIS was correlative with low histological differentiation （ X^2 = 10. 98, P 〈 0. 005 ）, PR negative （ P = 0. 019, Fisher exact probability）, and C-erbB-2 positive （ P = 0. 000 8, Fisher exact probability）. The expression of COX-2 in IDC was correlative with lymph node metastasis （ X^2 = 4. 09, P 〈 0. 05 ） , tissue poorly differentiated （ P = 0. 004, Fisher exact probability）, PR negative （ X^2 = 6. 91, P 〈 0. 01 ） and C-erbB-2 positive （ X^2 = 5.94, P 〈 0. 025 ）. Conclusion COX-2 does not express in normal mammary gland. It is high-expressed in BPBD, DCIS and IDC;These indicate the up-regulation of COX-2 expression not only participates in breast carcinogenesis, but

关 键 词：乳腺肿瘤 氧合酶类 基因 ERBB-2 受体 雌激素 受体 孕酮 

分 类 号：R737.9[医药卫生—肿瘤]