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目的:探讨鼻咽癌(NPC)肿瘤组织中环氧合酶-2(COX-2)的表达与NPC放疗效应的关系,评估COX-2在预测NPC患者放疗效应中的价值,为制订个性化治疗方案提供理论依据,提高患者的生存率和生存质量。方法:应用免疫组织化学法检测30例放射敏感和30例放射抵抗的鼻咽低分化鳞状细胞癌患者在接受放疗前的肿瘤组织中COX-2蛋白的表达情况,分析COX-2的表达与放疗效应的关系。结果:COX-2在NPC中总的阳性表达率为61.67%。在30例放射抵抗的NPC组织中,COX-2表达阳性26例(86.67%),在30例放射敏感的NPC组织中,COX-2表达阳性11例(36.67%),2组比较,差异有统计学意义(P<0.01),2组间COX-2阳性表达强度差异亦有统计学意义(P<0.05)。根据COX-2阳性表达预测NPC患者放疗抵抗,敏感性86.67%,特异性63.33%,准确率75.00%,阳性预测值70.27%,阴性预测值82.61%,假阳性率36.67%,假阴性率13.33%。结论:COX-2可作为预测NPC患者放疗效应的一个指标,可根据治疗前NPC肿瘤组织中COX-2的表达情况选择相对合理的治疗方案。
Objective: To investigate the relationship between the expression of cyclooxygenase-2 (COX-2) and radiotherapy effect of NPC in nasopharyngeal carcinoma (NPC) and to evaluate the value of COX-2 in predicting the radiotherapy effect of NPC. Treatment programs provide a theoretical basis to improve patient survival and quality of life. Methods: Immunohistochemistry was used to detect the expression of COX-2 protein in 30 patients with nasopharyngeal poorly differentiated squamous cell carcinoma before radiotherapy and 30 patients with radiosensitivity. The expressions of COX-2 and Relationship between radiotherapy effects. Results: The total positive expression rate of COX-2 in NPC was 61.67%. COX-2 expression was positive in 26 cases (86.67%) of 30 radioresistant NPC tissues and 11 cases (36.67%) of COX-2 positive in 30 radiosensitive NPC tissues. There was significant difference between the two groups Statistical significance (P <0.01), COX-2 positive expression intensity between the two groups also had statistical significance (P <0.05). According to the positive expression of COX-2, the sensitivity of NPC patients was 86.67%, specificity 63.33%, accuracy 75.00%, positive predictive value 70.27%, negative predictive value 82.61%, false positive rate 36.67%, false negative rate 13.33% . Conclusion: COX-2 can be used as an index to predict the radiotherapy effect in patients with NPC. According to the expression of COX-2 in NPC tissues before treatment, COX-2 is selected as a relatively reasonable treatment regimen.