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目的研究胃癌组织中环氧合酶2(COX-2)、Ki-67的表达和微血管密度(MVD)及其与临床病理因素的相互关系,探讨影响胃癌复发的因素。方法回顾性分析48例胃癌复发病例的临床病理特征,并以48例无复发病例作为对照。用免疫组织化学方法检测胃癌标本中COX-2、Ki-67 的表达和MVD,并分析三者之间及其与临床病理因素的相关性。用单因素和多因素分析影响胃癌复发的相关因素。结果胃癌组织中COX-2、Ki-67的表达与MVD两两之间高度相关,并且都与浸润深度和TNM分期密切相关。复发组病例术前存在盆腔转移结节、浸润深度达浆膜或浆膜以外以及 Borrmann分型Ⅲ型和Ⅳ型的比例明显增多,COX-2高表达和MVD明显增多,差异具有统计学意义 (P<0．05)。浸润深度、盆腔转移结节、COX-2高表达和MVD是胃癌复发的高危因素。结论 COX-2高表达、MVD、浸润深度、盆腔转移结节是胃癌复发的独立影响因素。
Objective To investigate the expression of cyclooxygenase 2 (COX-2), Ki-67 and MVD in gastric cancer and its relationship with clinicopathological factors, and to explore the factors influencing the recurrence of gastric cancer. Methods A retrospective analysis of 48 cases of gastric cancer recurrence of the clinicopathological features, and 48 cases without recurrence as a control. The expression of COX-2, Ki-67 and MVD in gastric cancer specimens were detected by immunohistochemistry, and the correlation between the three and clinicopathological factors was analyzed. Using univariate and multivariate analysis to analyze the related factors of gastric cancer recurrence. Results The expressions of COX-2 and Ki-67 in gastric cancer tissues were highly correlated with MVD, and were closely related to the depth of invasion and TNM stage. There were pelvic metastasis nodules in the recurrence group, the infiltration depth beyond the serosa or serosa and Borrmann type Ⅲ and Ⅳ significantly increased, COX-2 overexpression and MVD increased significantly, the difference was statistically significant ( P <0.05). Invasion depth, pelvic metastasis nodules, COX-2 overexpression and MVD are risk factors for gastric cancer recurrence. Conclusions COX-2 overexpression, MVD, depth of invasion, and pelvic metastasis nodules are independent prognostic factors for gastric cancer recurrence.