摘要
目的:淋巴道转移是乳腺癌的主要转移途径之一。环氧化酶-2催化具有多种生物学活性的前列腺素的合成,其过表达提示癌细胞的侵袭和转移能力增强;血管内皮生长因子-C是VEGF家族新成员,为重要的淋巴管生成因子,促进乳腺癌淋巴管的生成和增殖,二者在乳腺癌淋巴道转移中均具有重要的作用。本研究探讨乳腺癌患者癌组织中环氧化酶-2表达和血清中血管内皮生长因子-C水平与乳腺癌淋巴转移的相关性。
方法:1.采用RT-PCR法检测54例乳腺癌患者的癌组织、相应癌旁及正常组织和30例乳腺良性肿瘤患者的肿瘤组织中COX-2表达情况;2.采用ELISA法检测上述54例乳腺癌患者和30例乳腺良性肿瘤患者术前、术后血清及30例正常人血清中VEGF-C水平;分析两者与肿瘤的组织类型、临床分期和腋窝淋巴结转移的关系,探讨两者在乳腺癌淋巴转移中的作用。
结果:1.54例癌组织中42例COX-2表达(78%),癌旁组织中7例表达(13%),正常乳腺组织5例表达(9%),30例良性肿瘤组织中3例表达(10%),COX-2在癌组织中的表达明显高于非癌组织(癌旁组织、正常乳腺组织、良性肿瘤组织),差异具有统计学意义(P＜0.05),在各非癌组织之间COX-2表达无显著差异(P＞0.05);在38例Ⅰ、Ⅱ期乳腺癌患者中,有17例COX-2表达(45%),16例Ⅲ期患者中,有10例表达(63%),两者相比差异具有统计学意义(P＜0.05);34例有腋窝淋巴结转移患者中28例COX-2表达(82%),20例无腋窝淋巴结转移的患者中,6例表达(30%),两者相比差异具有显著统计学意义(P＜0.05),相关性分析r=0.426,说明COX-2同乳腺癌淋巴转移有正相关性,提示COX-2可能促进乳腺癌的淋巴转移,而COX-2同肿瘤组织类型无关(P＞0.05)。
2.VEGF-C在乳腺癌患者术前血清中的水平为6142.98 pg/ml,高于在乳腺良性肿瘤患者术前血清中的水平5268.92 pg/ml和正常人血清中水平4967.16pg/ml,差异具有统计学意义(P＜0.05);VEGF-C在有腋窝淋巴结转移的乳腺癌患者术前血清中的水平为6369.27pg/ml,明显高于无腋窝淋巴结转移的乳腺癌患者术前血清中的水平5884.90 pg/ml,两者相比具有统计学差异(P＜0.01),相关性分析r=0.716,说明VEGF-C同淋巴结转移呈正相关,提示VEGF-C可能促进乳腺癌的淋巴转移;Ⅰ、Ⅱ期乳腺癌患者术前血清中的VEGF-C水平为5346.87pg/ml,Ⅲ期患者术前血清中的VEGF-C水平为5962.13 pg/ml,明显高于Ⅰ、Ⅱ期(P＜0.05),而VEGF-C同肿瘤组织类型无关(P＞0.05)。
3.COX-2和VEGF-C在有腋窝淋巴结转移的乳腺癌患者中较无淋巴结转移者均表达增高,两者在乳腺癌淋巴结转移中呈正相关(r=0.629 P＜0.01),提示两者可能共同促进乳腺癌的淋巴转移。
结论:1.COX-2和VEGF-C与乳腺癌淋巴转移密切相关。
2.COX-2和VEGF-C表达在乳腺癌淋巴转移中呈正相关,二者可能共同促进乳腺癌的淋巴转移。
OBJECTIVE: lymphatic metastasis of breast cancer is one of the main means of transfer in breast cancer. COX-2 catalyses prostaglandin synthesis which has a variety of biological activity, its excessive expression enhances tumor cell invasion and metastasis, VEGF-C is a new member in VEGF family, which is an important factor in lymphangiogenes,it promote the proliferation of lymphangiogenes in breast cancer, the COX-2 and VEGF-C play important roles both in breast cancer metastasis.To explore the correlation of the expression of COX-2 and the level of serum VEGF-C with the lymphatic metastasis of breast cancer.
METHOD: 1. The expression level of COX-2 was detected in cancer tissues, paracarcinoma breast tissues, normal breast tissues of 54 patients with breast cancer and benign tumor tissue of 30 patients with breast benign tumor by RT-PCR.
2. The level of VEGF-C in the serum of the 54 patients with breast cancer, 30 patients of breast benign tumor and 30 cases of normal people was detected by ELISA.
RESULTS: 1. the expression of COX-2 of the 42 cases breast cancer patients was increased in the 54 cases (78%), in the paracarcinoma breast tissues, it was increased in 7cases(13%), in normal breast tissues, it was no expression , and benign tumor tissue ,there was 3cases expression(9%).Compared with non-cancer tissues group, it was statistically increasing in cancer tissues group (P<0.05) , but there were no differences of COX-2 expression in the non-cancer tissues group (P>0.05). the expression level of COX-2 of the 17 cases I、II stages breast cancer patients was increased in the 38 cases (45%), in 16 cases III stages breast cancer patients, there were 10 cases patients increased(63%), Obvious difference of the expressions of COX-2 existed between the two groups (P<0.05) . the expression level of COX-2 of the 28 cases positive group of axillary lymphnode metastasis was increased in the 34 cases (82%), in 20 cases negtive group, there were 6 cases increased(30%). Obvious difference of the expressions of COX-2 existed between the two groups (P<0.05). there are positive correlation between COX-2 and lymphatic metastasis of breast cancer, r=0.426,suggesting that COX-2 may promote the lymphatic metastasis of breast cancer . However, there were no correlations with tumor histological type.
2. The level of VEGF-C in preoperative serum of patients with the breast cancer (6142.98 pg/ml)and 30 patients of breast benign tumor (5268.92 pg/ml) was significantly different(P<0.05), that obviously higher in positive groups of axillary lymphnode metastasis breast cancer (6369.27 pg/ml) than in positive group (5884.90 pg/ml) , Obvious difference of the level of VEGF-C existed between the two groups (P<0.01) . there are positive correlation between VEGF-C and lymphatic metastasis of breast cancer, r=0.716,suggesting that COX-2 may promote the lymphatic metastasis of breast cancer . the level of VEGF-C is 5346.87 pg/ml in preoperative serum of I、II stages breast cancer patients, in III stages breast cancer patients is 5962.13 pg/ml, it is obviously higher than former(P<0.05). However, the VEGF-C had no correlations with tumor histological type.
3. the expression of COX-2 and VEGF-C was significantly increased in lymph node metastasis breast cancer than those without lymph node metastasis, there are positive correlation between COX-2 and VEGF-C in lymphatic metastasis breast cancer (r=0.629 P<0.01) . However, they had no correlations with tumor histological type.
CONCLUSION: 1. The COX-2 and VEGF-C is closely related to transfer of the lymphaticmetastasis in breast cancer.
2. The COX-2 and VEGF-C are positively correlated in the expression oflymphatic metastasis of breast cancer, the two maybe promote thelymphatic metastasis of breast cancer jointly.
引文
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