Stewart Ashley E, Heslin Martin H, Arch Jorge, Jhala Nirag, Ragland Brian, Gomez Fernando, Bland Kirby I, Arnoletti J Pablo
Department of Surgery, University of Alabama at Birmingham, 1922 7th Avenue South, Birmingham, AL 35294, USA.
J Gastrointest Surg. 2006 Feb;10(2):315-9. doi: 10.1016/j.gassur.2005.05.012.
The significance of cyclooxygenase-2 (COX-2) expression in mesenchymal tumors has not been completely described. We analyzed clinicopathologic variables and COX-2 protein expression in all mesenchymal tumors of the GI tract that were treated at our institution between 1990 and 2002. Paraffin-embedded specimens were immunohistochemically stained for KIT and COX-2 protein. KIT-positive tumors were diagnosed as gastrointestinal stromal tumors (GIST). Among 42 available specimens, 38 tumors were diagnosed as GIST and four were non-GIST mesenchymal GI tumors (KIT negative). The median overall survival for the GIST patients was 34 months. Ninety-two percent of GIST expressed COX-2 protein. COX-2 protein was not expressed in any of the non-GIST tumors. GIST patients with negative or low COX-2 expression developed disease recurrence and/or died of their disease in 37% of the cases, compared with 18% for GIST patients with high COX-2 expression (difference not statistically significant). The vast majority of mesenchymal tumors of the GI tract are GIST that express COX-2 protein. As opposed to known predictors of GIST behavior such as tumor size and mitotic count, levels of COX-2 protein expression did not correlate with clinical outcome.
环氧化酶-2(COX-2)在间叶组织肿瘤中的表达意义尚未完全阐明。我们分析了1990年至2002年间在我院接受治疗的所有胃肠道间叶组织肿瘤的临床病理变量及COX-2蛋白表达情况。石蜡包埋标本进行KIT和COX-2蛋白的免疫组织化学染色。KIT阳性肿瘤诊断为胃肠道间质瘤(GIST)。在42份可用标本中,38例肿瘤诊断为GIST,4例为非GIST胃肠道间叶组织肿瘤(KIT阴性)。GIST患者的中位总生存期为34个月。92%的GIST表达COX-2蛋白。非GIST肿瘤均未表达COX-2蛋白。COX-2表达阴性或低表达的GIST患者中37%出现疾病复发和/或死于疾病,而COX-2高表达的GIST患者这一比例为18%(差异无统计学意义)。胃肠道间叶组织肿瘤绝大多数是表达COX-2蛋白的GIST。与GIST行为已知的预测指标如肿瘤大小和有丝分裂计数不同,COX-2蛋白表达水平与临床结局无关。