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目的研究环氧合酶-2(cyclooxygenase-2,COX-2)蛋白在不同亚型胃黏膜肠化生(intestinal metaplasia,IM)及胃癌中的表达,探讨其做为预测IM恶变趋势指标的可能性,同时明确COX-2表达与胃癌发生间的关系。方法选择40例慢性萎缩性胃炎(chronic、atrophic gastritis,CAG)伴IM、40例胃癌及相应癌旁组织,构建组织芯片。分别用高铁二铵/爱先蓝(HID/AB)及HE染色对IM及胃癌进行分型,免疫组化检测不同亚型IM及胃癌中COX-2蛋白的表达。结果COX-2蛋白表达阳性率在CAG伴IM灶、癌旁IM灶和肠型胃癌中分别为45.65%、59.38%和77.27%,显著高于弥漫型胃癌(16.67%,P分别<0.05、0.005和0.005),表达强度在CAG伴IM灶→癌旁IM灶→肠型胃癌顺序中呈逐渐升高趋势(P<0.005)。Ⅲ型IM中COX-2表达阳性率显著高于Ⅰ型、Ⅱ型IM(P分别<0.005、0.05),从Ⅰ型、Ⅱ型到Ⅲ型,COX-2表达强度也呈逐渐升高趋势(P<0.005)。结论随着IM愈倾向于恶性,COX-2表达水平也逐渐增高,有可能成为预测IM恶变趋势的有用指标。COX-2表达主要与肠型胃癌的发生有关,但在弥漫型胃癌的发生中可能也有一定作用。
Objective To investigate the expression of cyclooxygenase-2 (COX-2) protein in different subtypes of gastric metaplasia (IMM) and gastric cancer and to explore its potential as a predictor of malignant transformation of IM Sex, at the same time a clear COX-2 expression and the relationship between gastric cancer. Methods Forty cases of chronic atrophic gastritis (CAG) with IM, 40 cases of gastric cancer and corresponding paracancerous tissues were selected to construct tissue microarray. Immunohistochemistry was used to detect the expression of COX-2 protein in different subtypes of IM and gastric cancer by high-speed diammonium / Acylan (HID / AB) and HE staining respectively. Results The positive rates of COX-2 protein in CAG with IM, adjacent non-cancerous lesions and intestinal type of gastric cancer were 45.65%, 59.38% and 77.27%, respectively, which were significantly higher than those in diffuse gastric carcinoma (16.67%, P <0.05, 0.005 And 0.005). The intensity of expression increased gradually in the sequence of CAG with IM → paracancer IM → intestinal type of gastric cancer (P <0.005). The positive rate of COX-2 expression in type III IM was significantly higher than that in type I and type II IM (P <0.005, 0.05 respectively). The expression intensity of COX-2 also gradually increased from type I to type II to type III P <0.005). Conclusion As IM tends to be malignant, the expression level of COX-2 also gradually increases, which may become a useful indicator to predict the malignant transformation of IM. COX-2 expression is mainly associated with the occurrence of intestinal-type gastric cancer, but may also play a role in the occurrence of diffuse gastric cancer.