P53、COX2、CD44V6在早期宫颈鳞癌脉管瘤栓阳性、阴性中的表达及与预后的关系  

Expression of P53, COX2 and CD44V6 in early-stage squamous carcinoma of cervix with lymph vascular space invasion positive and negative and its relationship with prognosis

作　　者：张蓉[1] 宋燕[2] 高维娇 张询[2] 佐晶[1] 雷呈志[1] 王晔[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院妇瘤科,北京100021 [2]中国医学科学院中国协和医科大学肿瘤医院病理科,北京100021 [3]北京大学临床肿瘤学院

出　　处：《中华医学杂志》2009年第47期3341-3345,共5页National Medical Journal of China

摘　　要：目的探讨早期宫颈癌脉管瘤栓（LVSI）与各临床病理参数的关系及P53、COX2、CIM4V6在早期宫颈癌中的表达及与预后的关系。方法对象为早期宫颈癌脉管瘤栓阳性44例，对照组为相对应的脉管瘤栓阴性44例宫颈癌患者。采用免疫组织化学方法监测P53、COX2、CD44V6的表达情况，分析脉管瘤栓、P53、COX2、CIM-4V6与临床病理参数之间的关系及对预后的影响。结果脉管瘤栓阳性与淋巴结转移、深肌层受侵明显相关，脉管瘤栓阳性、阴性者5年无瘤存活分别为68．9％、94．7％，P〈0．01，总存活率为70．2％、100％，P〈0．01。COX2与临床期别、肿瘤大小有相关性，P53、CIM4V6与临床参数之间无相关性。P53、COX2、CIM4V6阳性患者生存时间短于阴性患者，特别是三者均阳性患者无瘤存活时间（DFS）、总存活时间（0s）分别为60．0，67．3个月，三者均阴性患者分别为73．6，91．3个月，但差异无统计学意义。结论早期宫颈鳞癌中脉管瘤栓阳性与淋巴结转移、深肌层受侵相关，与5年无瘤存活、总存活负相关，COX2与肿瘤大小、临床期别相关，P53、CIM4V6与临床各因素无关，P53、COX2、CIM4V6阳性者存活期短于阴性者。Objective To investigate the relationship between lymph vascular space invasion （LVSI） and various clinicopathologic factors in early-stage cervical squamous carcinoma; to explore the expression of P53, COX2 and CD44V6 in early stage squamous carcinoma of cervix and its relationship with prognosis. Methods A case-controlled study was conducted to compare LVSI positive group （n = 44） in early stage squamous carcinoma of cervix with LVSI negative group （ n = 44）. Expression of P53, COX2 and CD44V6 were evaluated by immunohistochemical method to analyze the relationship between LVSI, P53, COX2 and CD44V6 and various clinicopathologic factors and to investigate their prognostic influences. Results I,VSI positive was correlated with lymph node metastasis and deep stromal invasion. The 5-year disease-free survival was 68.9% in LVSI positive group versus 94. 7% in LVSI negative group （P 〈0. 01）. And the 5-year overall survival was 70. 2% in LVSI positive group versus 100% in LVSI negative group （P 〈0. 01 ） with a significant difference. COX2 was correlated with clinical stage and tumor volume while there was no correlation with P53, CD44V6 and clinical factors. The overall survival of P53, COX2 and CD44V6 positive cases were significantly shorter than that of negative ones, especially in constant positive cases of 3 markers （disease-free survival 60.0 months shorter than constant negative cases with an overall survival of 91.3 months, but there was no significant difference）. Conclusion LVS1 is correlated with lymph node metastasis and deep stromal invasion in the early-stage squamous carcinoma of cervix while it is negatively correlated with disease-free survival and overall survival. COX2 is correlated with clinical stage and tumor volume. Furthermore P53 and CD44V6 are not correlated with clinical factors. The overall survival of P53, COX2 and CD44V6 positive cases are significantly shorter than that of negative ones.

关 键 词：宫颈肿瘤 预后 P53 COX2 CD44V6 

分 类 号：R737.33[医药卫生—肿瘤] R735.2[医药卫生—临床医学]