COX2表达水平与食管鳞癌同步放化疗敏感性的相关性研究

摘要

目的：评估COX2表达水平与食管鳞癌同步放、化疗敏感性的关系，探讨COX2作为预测食管癌同步放、化疗疗效生物靶向标识的可行性。方法选取20例初治食管癌患者，病理诊断均为鳞癌。均行术前同步放、化疗＋食管癌根治术。术后病理标本采用免疫组织化学方法测定 COX2的表达水平，并分析其与食管鳞癌同步放、化疗敏感性的关系。结果20例病理标本中COX2弱表达（n＝3）、中等表达（n＝9）、强表达（n＝8）者病理缓解率分别为87．5％、55．6％、33．3％，COX2表达水平与病理缓解率有关（P＝0．005），也和治疗效果密切相关（Kendall’s sb＝0．396，P＝0．001）。COX2表达水平与性别、年龄、有无淋巴结转移、肿瘤深度及肿瘤大小无关（P＞0．05）。单因素分析显示COX2无表达或者弱表达与同步放、化疗疗效有关（OR 6．285，95％CI 1．49～25．126；P＝0．010）。多因素分析显示COX2弱表达为判断疗效的独立预测指标（OR 6．485，95％CI 1．509～27．800；P＝0．010）。多因素分析显示COX2弱表达（≤30％）可作为食管鳞癌预后判断的独立预测因子（OR 6．551，95％CI 1．540～27．911；P＝0．009）。结论 COX2表达水平可预测食管鳞癌同步放、化疗的敏感性，同时 COX2可作为评估食管癌同步放、化疗疗效的生物靶向标识。%Objective To evaluate the correlation between COX2 expression and concurrent chemoradiotherapy sensitivity in esophageal squamous cell carcinoma,and to investigate the feasi-bility of COX2 as a biomarker for evaluating the efficacy of concurrent chemoradiotherapy.Meth-ods Twenty patients with pathology-confirmed esophageal squamous cell carcinoma were en-rolled in this study.All patients underwent concurrent chemoradiotherapy and radical esophagec-tomy.COX2 expression was detected by immunohistochemical staining.The correlation between COX2 expression and concurrent chemoradiotherapy sensitivity was analyzed.Results The patho-logical remission rate was 87.5% in specimens with weak COX2 expression,55.6% in specimens with moderate COX2 expression,and 33.3% in specimens with strong COX2 expression.The ex-pression of COX2 was correlated with pathological remission rate(P=0.005)and response rate (Kendall’s sb=0.396,P=0.001),but was not correlated with gender,age,lymph node metasta-sis,tumor depth and tumor size(P>0.05).Univariate analysis showed that the negative or weak COX2 expression was related to concurrent chemoradiotherapy(OR 6.285,95%CI 1.49-25.126;P=0.010).Multivariate analysis showed that the weak COX2 expression(≤30%)was an inde-pendent prognostic factor for esophageal squamous cell carcinoma(OR 6.485,95% CI 1.509-27.800;P=0.010).Conclusion The COX2 expression can predict concurrent chemoradiotherapy sensitivity in esophageal squamous cell carcinoma,and can be used as a feasible biomarker for e-valuating the efficacy of concurrent chemoradiotherapy.