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目的:探讨老年胃癌患者原发灶及淋巴结转移灶中环氧合酶2(COX-2)与凋亡抑制蛋白p53,survivin,Bcl-2表达的关系及其意义。方法:用免疫组化染色法检测33例伴淋巴结转移的老年胃癌患者(≥60岁)手术标本中COX-2,p53,survivin和Bcl-2的表达情况,同法检测32例对照组(<60岁)胃癌原发灶、转移灶中上述4种蛋白的表达,比较两组之间、淋巴结转移灶与原发灶之间的表达差异,并进行相关分析。结果:老年组转移灶中Bcl-2的表达高于原发灶(P<0.05),COX-2,p53和survivin表达在两种病灶组织间无统计学差异(均P>0.05),p53及Bcl-2表达在原发灶、转移灶间存在正相关(r分别为0.5470及0.4969,均P<0.01)。老年患者原发灶中COX-2与survivin,COX-2与Bcl-2之间呈正相关(r=0.5053;r=0.5741,均P<0.01),转移灶中survivin与Bcl-2表达呈负相关(r=-0.5414,P<0.01)。老年组原发灶COX-2,survivin和Bcl-2表达明显高于对照组(均P<0.05),而转移灶仅COX-2的表达高于对照组(P<0.05)。结论:大于60岁老年胃癌患者,原发灶与淋巴结转移灶的COX-2的表达与60岁以下的胃癌患者存在差异,这可能导致老年患者凋亡抑制途径与其他年龄患者不同。
Objective: To investigate the relationship between cyclooxygenase 2 (COX-2) and the expression of p53, survivin and Bcl-2 in primary gastric cancer and lymph node metastasis in elderly patients with gastric cancer. Methods: The expressions of COX-2, p53, survivin and Bcl-2 in 33 specimens of elderly patients with gastric cancer with lymph node metastasis (≥60 years old) were detected by immunohistochemical staining, and 32 cases in control group (< 60 years old) primary gastric cancer, metastasis in the above four kinds of protein expression, compared between the two groups, lymph node metastasis and primary tumor between the expression differences, and correlation analysis. Results: The expression of Bcl-2 in the metastasis of the elderly group was higher than that of the primary lesion (P <0.05). There was no significant difference in the expression of COX-2, p53 and survivin between the two groups (all P> 0.05) There was a positive correlation between Bcl-2 expression in primary tumor and metastasis (r = 0.5470 and 0.4969, all P <0.01). There was a positive correlation between the expression of COX-2 and survivin, COX-2 and Bcl-2 in elderly patients (r = 0.5053; r = 0.5741, all P <0.01) (r = -0.5414, P <0.01). The expression of COX-2, survivin and Bcl-2 in the primary group were significantly higher than those in the control group (all P <0.05), while the expression of COX-2 in the metastasis group was higher than that in the control group (P <0.05). Conclusion: The expression of COX-2 in primary and metastatic lymph nodes of patients older than 60 years old is different from that of patients under 60 years of age, which may result in the different pathways of apoptosis inhibition in elderly patients.