The Expression And Clinical Significance Of COX-2、Livin And Ki-67 In Sino-nasal Squamous Cell Carcinoma

ObjectiveIn this study,the expression of COX-2,Livin,Ki-67 in squamous cell carcinoma of nasal cavity and paranasal sinuses and the correlation among them were analyzed by immunohistochemical staining.To analyze their important role in the carcinogenesis of nasal cavity and paranasal sinus cell carcinoma,and to provide evidence for early clinical diagnosis,treatment and prognosis of this disease.Materials and methodsWe selected 52 patients with sinonasal squamous cell carcinoma who were surgically resected and whose clinical records were preserved from June 1,2012 to June 1,2017 in the Department of Otorhinolaryngology,the first affiliated Hospital of Zhengzhou University.All pathological specimens were confirmed by more than two pathologists.There are 29 males and 23 females,and the ratio of male to female is 1.26%.All patients received no preoperative radiotherapy,chemotherapy,targeted therapy and other anti-tumor therapy.18 cases of normal inferior turbinate mucosa in transnasal benign tumor resection or septum deviation correction were selected as normal control group.We used immunohistochemical method to detect the expression of COX-2,Livin,Ki-67 in squamous cell carcinoma of nasal cavity and paranasal sinuses and normal inferior turbinate mucosa.The positive expression rate of the three factors in the experimental group and the control group was analyzed,and the correlation between the three factors was analyzed.Finally,the relationship between cox-2,livin,ki-67 and clinical features and prognosis of nasal cavity and paranasal sinus squamous cell carcinoma was analyzed.All patients were followed up until February 28,2019.The total survival time was between the time of diagnosis of the disease and the time of death or last follow-up.The statistical analysis was carried out with spss 21.0 software.Non-parametric test(Mann-Whitney rank sum test)was used to compare the two groups of independent sample rank data(expression intensity of three factors).The positive rate of the other two groups of independent samples was compared by chi-square test(fisher accurate test if necessary),with a significant difference in p< 0.05.Spearman rank correlation analysis was used to study the correlation between the three factors.There was a positive correlation between the two factors when r > 0,and a negative correlation between the two factors when r < 0.The difference was statistically significant(P < 0.05).Results1.The positive expression site of COX-2 was mainly located on the cell membrane,which was brown-yellow granular,and the negative expression was blue granular.The positive expression rate of COX-2 was 75%(39 / 52)in 52 cases of SNSCC and 16.67%(3 / 18)in normal mucosa of inferior turbinate.The difference between the two groups was statistically significant(Z=-4.176,p<0.0 5).The positive expression rate of COX-2 in stage I and II squamous cell carcinoma was 47.06%,and that in stage III and IV was 88.57%.The difference was statistically significant(p < 0.05).The positive expression rate of high differentiated squamous cell carcinoma was 50% and that of middle and low differentiated squamous cell carcinoma was 84.21%.The difference was statistically significant(p < 0.05).The expression of COX-2 was not related to sex and age of patients(p > 0.05).2.The positive expression of Livin was mainly located in the cytoplasm,followed by the nucleus,mainly yellow and brown granular.The positive rate of Livin was 86.54%(45 / 52)in SNSCC group and 33.33%(6 / 18)in normal inferior turbinate mucosa group.The difference between the two groups was statistically significant(z=-4.366,p<4.366).The positive expression rate of Livin in stage III and IV squamous cell carcinoma patients(97.14%)was higher than that in stage I and stage II(64.71%),and the difference was statistically significant(p < 0.05).The positive expression rate of moderate and poorly differentiated squamous cell carcinoma(94.74%)was significantly higher than that of well-differentiated squamous cell carcinoma(64.29%)(p < 0.05).The expression of Livin was not related to sex and age of patients(p > 0.05).3.The nucleus is the main site of Ki-67 positive expression.The positive rate of Ki-67 expression was 88.46%(46/52)in sinonasal squamous cell carcinoma and 38.89%(7/18)in normal control group.The difference was statistically significant(z=-4.508,p<4.508).The positive rate of Ki-67 was 70.59% in stage I and II,97.14% in stage III and IV,and the difference was statistically significant(p <0.05).The positive rate of highly differentiated squamous cell carcinoma(64.29%)was lower than that of poorly differentiated patients(97.37%),and the difference was statistically significant(p <0.05).The expression of Ki-67 was not related to sex and age of patients(p>0.05).4.The correlation of cox-2,livin,ki-67 expression in sinonasal squamous cell carcinoma was found by spearman rank correlation analysis.There was a positive correlation between COX-2 and Ki-67 expression in SNSCC(r=0.348,p<0.05).There was a positive correlation between the expression of Livin and Ki-67 in SNSCC(r=0.387,p<0.05),but no correlation between the expression of COX-2 and Livin in SNSCC(r=0.033,p>0.05).5.The overexpression of COX-2 in SNSCC was related to the prognosis.The survival rate of patients with moderate or strong positive expression(46.9%)was lower than that of patients with negative or weak positive(80.0%).There was a significant difference between the two groups(P < 0.05).The expression intensity of livin was correlated with the prognosis of the patients.The survival rate of the patients with negative or weak positive expression(86.7%)was higher than that with moderate or strong positive expression(54.1%)(p < 0.05).The survival rate of patients with negative or weak positive expression of ki-67(80.9%)was significantly higher than that of those with moderate or strong positive expression(51.6%)(p < 0.05).Conclusion1.The occurrence and development of SNSCC may be related to the abnormal expression of cox-2,livin and ki-67.The overexpression of three factors is related to the clinical stage and pathological grade of squamous cell carcinoma of nasal cavity and sinuses.2.The expression of COX-2 and Ki-67,Livin and Ki-67 in sinonasal squamous cell carcinoma is synergistic.There was a positive correlation between the expression of COX-2 and Ki-67,Livin and Ki-67 in SNSCC,but no correlation between COX-2 and Livin in SNSCC.3.The expression intensity of cox-2,livin and ki-67 in SNSCC is related to the prognosis of the patient.The 5-year survival rate of the patients with moderate or strong positive expression was lower than that of the patients with negative or weak positive expression.4.Cox-2,Livin and Ki-67 can be used as molecular biomarkers for early diagnosis of sinonasal squamous cell carcinoma.In addition,the expression of three factors also plays an important role in the evaluation of malignant degree and prognosis of sinonasal squamous cell carcinoma.