Department of Oncology and Radiotherapy, Turku University Hospital, PL 52, FIN-20521 Turku, Finland.
Anticancer Res. 2010 Jul;30(7):3023-30.
Prognosis of renal cell carcinoma (RCC) differs within the same stage and grade. Our aim was to investigate the incidence of COX-2 in primary RCC tumors at different stages according to the occurrence of metastasis, and the impact of this biomarker on the survival of RCC patients.
The cytoplasmic/membranous COX-2 protein expression was examined by immunohistochemistry in RCC tumors from 102 patients. The patients were divided into those with: no metastasis during 7.5 years' follow-up (nm), no metastasis at the time of nephrectomy but who later developed metastases (lm), and those with metastasis at presentation (pm). The immunoreactivity of COX-2 was classified as none (absent/weak intensity in fewer than 10% of the cancer cells), low (weak intensity in over 10% of the cancer cells) or high immunostaining (strong intensity in the majority of the cancer cells). In addition p53 and Ki-67 immunostaining was also assessed in tumors.
Percentages of COX-2 reaction were (no/low/high): 78/16/7 in the nm, 53/28/19 in the lm, 92/8/0 in the pm groups (p=0.014). Median metastasis-free survival was shorter in lm patients with COX-2-negative tumors when compared to those with COX-2-positive ones (15 vs. 46 months; p=0.020). Median overall survival was shorter in pm/lm patients with COX-2-negative tumors when compared to those with COX-2-positive ones (28 vs. 94 months; p=0.027), and with COX-2-negative/Ki-67-positive tumors when compared to COX-2-positive/Ki-67-negative ones (19 vs. 97 months; p=0.004). Findings for patients with COX-2-negative/p53-positive tumors were similar, with shorter survival compared to those with COX-2-positive/p53-negative ones (19 vs. 97; p=0.006).
COX-2 protein expression is associated with slow development of metastases, and favourable prognosis in metastatic RCC.
肾细胞癌（RCC）在同一分期和分级内的预后存在差异。我们的目的是根据转移的发生情况，研究 COX-2 在原发性 RCC 肿瘤中的发生率，并探讨该生物标志物对 RCC 患者生存的影响。
通过免疫组织化学法检测 102 例 RCC 肿瘤中的 COX-2 细胞质/膜蛋白表达。将患者分为无转移（nm）、肾切除时无转移但随后发生转移（lm）和初诊时转移（pm）。将 COX-2 的免疫反应性分为无（少于 10%的癌细胞中存在弱强度）、低（10%以上的癌细胞中存在弱强度）或高（大多数癌细胞中存在强强度）。此外，还评估了肿瘤中的 p53 和 Ki-67 免疫染色。
nm、lm 和 pm 组的 COX-2 反应率分别为（无/低/高）：78/16/7、53/28/19 和 92/8/0（p=0.014）。与 COX-2 阳性肿瘤患者相比，COX-2 阴性肿瘤患者的 lm 患者无转移生存时间更短（15 与 46 个月；p=0.020）。与 COX-2 阳性/Ki-67 阴性肿瘤患者相比，pm/lm 患者 COX-2 阴性肿瘤患者的总生存时间更短（28 与 94 个月；p=0.027）。COX-2 阴性/p53 阳性肿瘤患者的结果类似，与 COX-2 阳性/p53 阴性肿瘤患者相比，生存时间更短（19 与 97 个月；p=0.006）。
COX-2 蛋白表达与转移性 RCC 中转移的缓慢发展和良好的预后相关。
