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目的观察肾细胞癌(RCC)中肿瘤细胞生长、转移及肿瘤血管增生与环氧化酶2(Cox-2)、乙酰肝素酶(Hpa)的关系。方法采用免疫组化链霉亲和素-生物素-酶复合物法(SABC)法检测60例RCC组织标本和30例癌旁肾组织标本中的Cox-2、Hpa、CD34表达,分析COX-2、Hpa表达和肿瘤血管增生的关系,及微血管密度(MVD)与RCC组织学分级、临床分期和预后的相关性。结果 60例RCC组织标本中,Cox-2阳性率为71.7%,Hpa阳性率为63.3%,与癌旁肾组织比较差异有统计学意义(χ2=24.308,χ2=20.089,P均<0.05);Cox-2表达与RCC肿块大小差异有统计学意义(χ2=4.34,P<0.05);Hpa表达与肿块大小无统计学意义,但与患者淋巴结转移有密切的相关性(χ2=12.72,P<0.05);Cox-2、Hpa阳性和阴性表达组织中MVD值分别是125.74±35.68和138.56±40.74、70.87±23.64和80.88±21.52,差异有统计学意义(P均<0.05);MVD与RCC组织学分级、临床分期和预后密切相关(P<0.05)。结论 Cox-2高表达与肿块大小有相关性;Cox-2和Hpa可促进血管增生;MVD与患者预后密切相关。
Objective To observe the relationship between tumor cell growth and metastasis, tumor angiogenesis and Cox-2, and heparanase (Hpa) in renal cell carcinoma (RCC). Methods The expressions of Cox-2, Hpa and CD34 in 60 specimens of RCC tissues and 30 specimens of adjacent tissues of cancer tissues were detected by immunohistochemical streptavidin-biotin-enzyme complex (SABC) method. The expressions of COX- 2, Hpa expression and tumor angiogenesis, and microvessel density (MVD) and RCC histological grade, clinical stage and prognosis. Results The positive rate of Cox - 2 and Hpa in 63 cases of RCC tissue samples were 71.7% and 63.3%, respectively (P <0.05). There was significant difference between the expression of Cox-2 and the size of RCC (χ2 = 4.34, P <0.05). The expression of Hpa was not correlated with the size of the tumor, but it was closely related to the lymph node metastasis (χ2 = 12.72, P < 0.05). The MVD in Cox-2 and Hpa positive and negative tissues were 125.74 ± 35.68 and 138.56 ± 40.74,70.87 ± 23.64 and 80.88 ± 21.52 respectively, with significant difference (P <0.05) The grade, clinical stage and prognosis were closely related (P <0.05). Conclusion The high expression of Cox-2 is correlated with tumor size. Cox-2 and Hpa promote angiogenesis. MVD is closely related to the prognosis of patients.