Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Prognostic Significance of Cyclooxygenase-2(COX-2) Expression in Primary, Resected Non-Small Cell Lung Cancer

원발성 비소세포폐암조직에서 Cyclooxygenase-2 발현의 예후인자로서의 의의

  • Kim, Hak Ryul (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Yang, Sei Hoon (Department of Internal Medicine, Wonkwang University College of Medicine) ;
  • Jeong, Eun Taik (Department of Internal Medicine, Wonkwang University College of Medicine)
  • 김학렬 (원광대학교 의과대학 내과학교실) ;
  • 양세훈 (원광대학교 의과대학 내과학교실) ;
  • 정은택 (원광대학교 의과대학 내과학교실)
  • Published : 2004.02.28
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Abstract

Background : Cyclooxygenase is the main target enzyme for the nonsteroidal anti inflammatory drugs (NSAIDs) that have been shown to suppress carcinogenesis in both experimental models and epidemiological studies. COX-2 plays an important role in solid tumor growth, invasiveness and angiogenesis, through, in part, the synthesis of prostaglandins, such as prostaglandin E2 (PGE2). In this study, the prognostic significance of an increase in COX-2 expression in lung cancer samples was evaluated. Material and Methods : The expression of COX-2, by immunohistochemistry, was studied in paraffin-embedded tumor blocks obtained from 84 patients(male 67, female 17, with a mean age of 63, ranging from 34 to 84 years) who had undergone surgery at Wonkwang University Hospital, between 1997 and 2002. For the evaluation of the relationships between COX-2 expression, and the clinical stage, metastasis to lymph nodes and survival, those cases showing the respective antigen expression in >10% of the tumor cells were considered positive. Result : Of the 84 patients, 61 (73%) exhibited more than 10% COX-2 immunoreactivities in the tumor and normal cells, whereas the remaining 23 showed no increase in the expression of COX-2. There was no significant relationship between the increased expression of COX-2 and the disease stage(p=0.1002) or cell type(p=0.152). The median survival was longer for the patients with a negative, compared to positive, COX-2 expression(36 compared to 24 months, p<0.05). The two year-survival rate was also higher in the patients with a negative COX-2 expression (78%) than those with a positive expression (47%, Kaplan-Meier, Log Rank, p < 0.05). Conclusion : The median survival was longer in the patients with a negative, compared to positive, COX-2 expression was longer than those with positive COX-2, having undergone complete resection due to primary non-small cell lung cancer.

연구배경 : Cyclooxygenase는 비스테로이드성 항염증제의 주요 작용부위로 실험적 모델이나 역학적 연구에서 암 발생을 억제하는 것으로 알려져 있다. COX-2는 prostaglandin E2와 같은 prostaglandin 합성을 통해 종양의 성장, 침윤 그리고 신생혈관에 중요한 역할을 하는 것으로 알려져 있다. 본 연구에서는 절제된 비소세포폐암조직에서 COX-2의 발현과 COX-2의 예후인자로서의 의의를 조사해 보았다. 대상 및 방법 : 1997년부터 2002년까지 본원에 내원하여 원발성 비소세포폐암으로 진단 받은 후 근치 목적의 절제술을 받았던 환자 84명을 대상으로 파라핀 포매된 조직을 택하여 면역 화학염색 방법을 통하여 COX-2 의 발현을 관찰하였다. COX-2가 발현된 암세포의 비율이 10% 이상인 경우를 양성으로 하였다. 결 과 : 평균 연령은 63세, 남녀 비는 67:17이었으며, 조직병리학적 분류는 편평상피암 53례, 선암 24례, 대세포암 7례였다. 병기는 I 병기 37례, II 병기 29례, IIIA 병기 18례였다. 총 84례 중 COX-2는 양성군이 73%(61/84례), 음성군이 27%(23/84례)이었다. COX-2 발현과 TNM 병기, 조직학적 분류와는 유의한 상관관계가 없었으나, 중간 생존기간은 COX-2 양성군이 음성군보다 통계적으로 유의하게 짧았다. 결 론 : 비소세포폐암에서 COX-2 항원 발현 음성군이 중간 생존기간이 길었다.

Keywords

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