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目的:分析和评价临床病理因素(年龄、临床分期、病理类型、组织学分级、癌灶大小、淋巴结转移)和生物学因素(HuR、VEGF及COX-2)与早期(Ⅰ～Ⅱ期)宫颈癌手术预后的关系。方法:采用免疫组化方法检测早期宫颈癌组织中HuR、VEGF及COX-2蛋白的表达,将可能与预后有关的因素进行单因素分析后再进行多因素分析。结果:癌灶大小、HuR蛋白阳性表达、COX-2蛋白阳性表达与预后相关(P均<0.05);临床分期、组织学分级、有无淋巴结转移、VEGF蛋白阳性表达与预后明显相关(P均≤0.01),不同年龄、病理类型与预后无关(P均>0.05)。组织学分级低者5年累计生存率显著低于组织学分级高者,前者死亡危险度是后者的2.948倍,是影响宫颈癌手术预后的第一位独立因素。其次为VEGF阳性表达,其相对危险度为2.801。结论:早期宫颈癌手术预后与临床分期、组织学分级、癌灶大小、有无淋巴结转移、HuR蛋白阳性、VEGF蛋白阳性、COX-2蛋白阳性有关,与年龄、病理类型无关。组织学分级、VEGF蛋白阳性是影响宫颈癌手术预后最显著的独立因素。
OBJECTIVE: To analyze and evaluate the relationship between the expression of HuR, VEGF and COX-2 and the clinical features of early stage (stage Ⅰ-Ⅱ) cervix and cervix (age, clinical stage, histological grade, histological grade, size of tumor, lymph node metastasis) Prognosis of cancer surgery. Methods: The expressions of HuR, VEGF and COX-2 protein in early stage cervical cancer tissues were detected by immunohistochemistry. Univariate analysis of possible prognostic factors followed by multivariate analysis. Results: The size of tumor, the expression of HuR protein and the expression of COX-2 protein were correlated with the prognosis (all P <0.05). The clinical stage, histological grade, lymph node metastasis and VEGF protein expression were positively correlated with prognosis ≤0.01), regardless of age, pathological type and prognosis (all P> 0.05). The 5-year cumulative survival rate of the lower histological grade was significantly lower than that of the histological grade, the former risk of death was 2.948 times the latter, is the first independent factor affecting the prognosis of cervical cancer surgery. Followed by VEGF positive expression, the relative risk was 2.801. Conclusions: The prognosis of early cervical cancer is related to clinical stage, histological grade, size of tumor, lymph node metastasis, positive HuR protein, positive VEGF protein and positive COX-2 protein, but not to age and pathological type. Histological grade, VEGF protein positive cervical cancer surgery prognosis is the most significant independent factor.