Expression Characteristics of COX2 and CDX2 in Laryngeal Squamous Cell Carcinoma and Their Prognostic Values in Patients with Laryngeal Squamous Cell Carcinoma
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摘要:
目的 研究COX2和CDX2在喉鳞癌发生发展过程中的表达特点及其与喉鳞癌患者预后的关系。 方法 采用免疫组化和计算机图像分析技术，观察喉息肉、喉乳头状瘤及喉鳞癌中COX2和CDX2的表达特点，并对其中的25位喉鳞癌患者进行随访以期了解COX2和CDX2对患者预后的影响。 结果 （1）COX2在喉鳞癌中的表达低于喉息肉（P = 0.004）和喉乳头状瘤（P = 0.001），T3-T4期喉鳞癌COX2表达比T1-T2期高，差异有统计学意义（P = 0.001）；有淋巴结转移喉鳞癌组高于无淋巴结转移喉鳞癌组，低、中、高分化喉鳞癌中的表达逐渐升高，但差异均无统计学意义（P > 0.05）；（2）CDX2在喉息肉、喉乳头状瘤中表达均较弱，在喉鳞癌中不表达，且差异无统计学意义（ P > 0.05）；（3）COX2蛋白表达阳性或阴性对患者的预后无影响。 结论 （1）COX2低表达可能与喉鳞癌的发生有关，但不能预测喉鳞癌患者的预后；（2）CDX2可能不是喉鳞癌的危险因素。 Abstract:Objective To investigate the expression characteristics of COX2 and CDX2 in the development of laryngeal squamous cell carcinoma and their relationship with the prognosis in patients with laryngeal squamous cell carcinoma. Methods The expression characteristics of COX2 and CDX2 in laryngeal polyps, laryngeal papilloma and laryngeal squamous cell carcinoma were detected at their protein levels by immunohistochemistry （IHC） and image analysis （IA） techniques in laryngeal squamous cell carcinoma. Twenty-five cases with laryngeal squamous cell carcinoma were followed up to understand the patient prognostic effects of COX2 and CDX2. Results 1. The expression of COX2 in laryngeal squamous cell carcinoma was lower than that of laryngeal polyps （P = 0.004） and laryngeal papilloma （P = 0.001）. The expression of COX2 in T3-T4 stage laryngeal squamous cell carcinoma was higher than that in T1-T2 stage, and the difference was statistically significant （P = 0.001）. The expression of COX2 in laryngeal squamous cell carcinoma with lymph node metastasis was higher than that in laryngeal squamous cell carcinoma without lymph node metastasis, the expression of COX2 increased gradually in low, medium and high differentiated laryngeal squamous cell carcinoma, but the differences were not statistically significant （P > 0.05）. 2. The expressions of CDX2 protein was weakly positive in laryngeal polyp and laryngeal papilloma, and the expressions of CDX2 protein was negative in laryngeal squamous cell carcinoma, and the difference was not statistically significant （ P > 0.05）. 3. Positive or negative expression of COX2 protein had no effect on the prognosis of patients. Conclusion 1. Low expression of COX2 may be associated with the development of laryngeal squamous cell carcinoma, but cannot predict the prognosis in patients with laryngeal squamous cell carcinoma. 2. CDX2 may not be a risk factor for laryngeal squamous cell carcinoma. -
图 1 COX2在喉息肉中的表达IHC（比例尺：100 µm×200）
Figure 1. Expression of COX2 protein in laryngeal polypus IHC （100 µm×200）
图 2 COX2在喉乳头状瘤中的表达IHC（比例尺：100 µm×200）
Figure 2. Expression of COX2 protein in laryngeal papilloma IHC （100 µm×200）
图 3 COX2在喉鳞癌中的表达IHC（比例尺：100 µm×200）
Figure 3. Expression of COX2 protein in laryngeal squamous cell carcinoma IHC（100 µm×200）
图 4 CDX2在喉息肉中的表达IHC（比例尺：100 µm×200）
Figure 4. Expression of CDX2 protein in laryngeal polypus IHC（100 µm×200）
图 5 CDX2在喉乳头状瘤中的表达IHC（比例尺：100 µm×200）
Figure 5. Expression of CDX2 protein in laryngeal papilloma IHC（100 µm×200）
图 6 CDX2在喉鳞癌中呈阴性表达IHC（比例尺：100 µm×200）
Figure 6. Negative expression of CDX2 protein in laryngeal squamous cell carcinoma IHC（100 µm×200）
图 7 COX2蛋白表达阳性和阴性喉鳞癌患者的生存曲线
Figure 7. Survival curves of patients with positive and negative COX2 protein expression
表 1 COX2在喉息肉、喉乳头状瘤和喉鳞癌中的表达（
$\bar x \pm s $ ）Table 1. The expression of COX2 in laryngeal polyps，laryngeal papilloma and laryngeal squamous cell carcinoma （
$ \bar x \pm s $ ）组别 n COX2表达 P 阳性单位（PU） 喉息肉 15 20.5987 ± 6.1766 1.000，0.004▲ 喉乳头状瘤 11 23.0000 ± 2.4537 0.001▲ 喉鳞癌 25 11.3664 ± 10.4782 与喉鳞癌比较，▲P < 0.05。 
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表 2 COX2在喉鳞癌中的表达与临床病理参数之间的关系（
$\bar x \pm s $ ）Table 2. The relationship between the expression of COX2 and clinicopathologic parameters in laryngeal squamous cell carcinoma （
$\bar x \pm s $ ）临床病理参数 n COX2表达 P 阳性单位（PU） 临床分期 T1～T2 16 6.6875 ± 8.9408 0.001 T3～T4 9 19.5778 ± 7.6142 颈淋巴结转移 （＋） 8 13.1500 ± 10.9172 0.571 （−） 17 10.5294±10.5008 分化程度 高分化 8 15.2275 ± 9.6195 1.000，0.169 中分化 11 12.3945±9.9813 0.381 低分化 6 4.3333±10.6145
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表 3 CDX2在喉息肉、喉乳头状瘤和喉鳞癌中的表达（
$\bar x \pm s $ ）Table 3. The expression of CDX2 in laryngeal polyps，laryngeal papilloma and laryngeal squamous cell carcinoma （
$\bar x \pm s $ ）组别 n CDX2表达 P 阳性单位（PU） 喉息肉 15 8.73 ± 1.20 0.455，0.052 喉乳头状瘤 11 5.01 ± 0.05 0.132 喉鳞癌 25 0
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表 4 COX2的表达与喉鳞癌患者预后的关系
Table 4. Relationship between expression of COX2 and prognosis of laryngeal squamous cell carcinoma patient
COX2表达 年生存率（%） 中位生存期 1 a 3 a 5 a 95%可信区间 P （＋） 85.71 34.29 34.29 1.70～4.30 0.078 （−） 90.91 90.91 40.40 3.00～7.00
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