Clinical Significance of Cyclooxygenase Expression in Stage I Human Squamous Cell Carcinoma of the Lung

背景　雖然早期診斷與適當的腫瘤切除對於患有初鱗狀上皮肺癌的病人相當有利，但是其五年存活率仍只有65%。最近流行病學的研究結果顯示，非類固醇消炎藥物可以減低罹患腫瘤的危險性，環氧?的表現因此被預估可能與癌病的預後有關。本研究是以免瘤染色法檢測肺癌細胞中第一型環氧?和第二型環氧?的表現，並以肺癌細胞中第一型環氧?和第二型環氧?的表現程度評估病人的預後情形。方法　本研究評估1987至1997年中88位以手術切除治療的初期鱗狀上皮肺癌病人，第一型環氧?和第二型環氧?在肺癌細胞中的表現是以免疫組織染色法檢測，然後以半定量的方法評估其與預後的關係。結果　第一型環氧?和第二型環氧?的表現，可分別在62.6%與71.1%的肺癌檢體中檢測出來。肺癌細胞表現第一型環氧?者有較早復發的傾向，而且其存活期較活。使用單變數分析這群患有初期鱗狀上皮肺癌的病人時，肺癌細胞表現第一型環氧?者、細胞分化程度較差者及有吸煙習慣者，其預後狀況較差；反之，以第二型環氧?的表現為預後因子評估腫瘤轉移的能力時，並無顯著差異。結論　初期鱗狀上皮肺癌中第一型環氧?的表現能預測腫瘤的惡化程度，腫瘤細胞表現一型環氧?的病人，通常有提前復發的傾向，但是使其能真正反映鱗狀上皮肺癌惡化之機轉，則有待較多及較久的追蹤研究。

關鍵字

環氧?,肺鱗狀上皮癌

並列摘要

Background. With early diagnosis and adequate resection, the 5-year survival rate for patients with stage 1 lung cancer is approximately 65%. Recent results of epidemiological studies have indicated that nonsterolidal anti-inflammatory drugs may reduce the risk of cancer; expressions of cycloxygenases (COX) are therefore anticipated to be associated with the prognosis of lung cancer patients. In this study, we evaluated the expressions of COX-1 and COX-2 in lung cancer cells and assessed their prognostic significance. Methods. From 1987 to 1997, we collected samples of stage I squamous cell carcinoma (SCC) of lung from 88 patients who had undergone complete surgical resection. Clinical data were recorded including the time and the location of tumor recurrence. Expressions of COX-1 and COX-2 in paraffin embedded tumor samples were determined by immunohistochemstry and scored with a semi-quantitative method. Results. Expressions of COX-1 and COX-2 were detected in 52(62.6%) and 59(71.1%) of 83 patients, respectively. Compared with patients with low COX-1 expression, patients with COX-1 expression had a significantly higher incidence of early tumor recurrence. Patients without COX-1 expression also had better survival rates than those with COX-1 expression. Using univariate analysis, expressions of COX-1, poor cell differentiation and smoking habits were the three important factors correlated with poor prognosis for patients with stage I SCC of lung. However, no significant difference was observed when COX-2 expression was used as a biological marker to evaluate the metastatic potential. Conclusions. COX-1 expression in stage I SCC of the lung predicted tumor aggressiveness. Early tumor recurrence is frequently occurred in patients with COX-1 expression.

並列關鍵字

cyclooxygenase,prognostic significance,squamous cell carcinoma of lung

國際替代計量

Clinical Significance of Cyclooxygenase Expression in Stage I Human Squamous Cell Carcinoma of the Lung

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