PAR-2、COX-2在嗜酸性慢性鼻-鼻窦炎鼻息肉患者组织中的表达及其临床意义-现代医学

PAR-2、COX-2在嗜酸性慢性鼻-鼻窦炎鼻息肉患者组织中的表达及其临床意义

单位：西宁市第一人民医院耳鼻喉科, 青海西宁 810001

分类号：R765.2;R765.41

出版年·卷·期（页码）：2022·50·第三期（336-342）

摘要：

目的：探讨蛋白酶激活受体2(PAR-2)及环氧化酶-2(COX-2)在慢性鼻-鼻窦炎鼻息肉(CRSwNP)患者组织中的表达水平及关系，并分析其临床意义。方法：选取2017年11月至2020年11月本院收治的CRSwNP患者133例，将其分为嗜酸性慢性鼻窦炎鼻息肉(ECRSwNP)组70例、非嗜酸性慢性鼻窦炎鼻息肉(non-ECRSwNP)组63例，另同期选取因行鼻中隔偏曲矫正术或下鼻甲肥大切除术患者70例为对照组。取其鼻黏膜组织，对3组标本进行苏木精-伊红(HE)染色；分别采用实时荧光定量PCR(qRT-PCR)法、免疫组织化学法测定组织中PAR-2、COX-2 mRNA水平及其蛋白表达情况；采用Pearson相关系数法分析PAR-2、COX-2 mRNA水平与Lund-Mackay评分相关性。结果：ECRSwNP组组织上皮下间质可见大量双核红染的嗜酸性粒细胞，non-ECRSwN组组织嗜酸性粒细胞较少；ECRSwNP组嗜酸性粒细胞百分比显著高于non-ECRSwN组(P<0.05)。PAR-2蛋白定位于组织黏膜上皮细胞及下腺体细胞胞浆及胞膜，COX-2蛋白主要定位于组织黏膜上皮细胞胞浆及胞膜，均呈棕黄色颗粒；ECRSwNP组、non-ECRSwN组Lund-Mackay评分、PAR-2、COX-2 mRNA水平及蛋白表达阳性率均显著高于对照组，ECRSwNP组Lund-Mackay评分、PAR-2、COX-2 mRNA水平及蛋白表达阳性率均显著高于non-ECRSwN组(P<0.05)；Pearson相关系数法结果显示ECRSwNP患者组织标本中PAR-2、COX-2 mRNA水平与Lund-Mackay评分均呈正相关，且PAR-2 mRNA与COX-2 mRNA水平呈正相关(P<0.05)。结论：PAR-2、COX-2在ECRSwNP患者鼻窦组织中异常高表达，且可一定程度反映病情严重程度，可作为病情判断及疗效观察的潜在指标。

Objective: To investigate the expression levels and relationship of protease-activated receptor(PAR-2) and cyclooxygenase-2(COX-2) in the tissues of patients with chronic rhinosinusitis with nasal polyps(CRSwNP), and analyze their clinical significance. Methods: One hundred and thirty-three patients with CRSwNP admitted to our hospital from November 2017 to November 2020 were selected, and they were divided into eosinophilic chronic sinusitis with nasal polyps(ECRSwNP) group(70 cases), non-eosinophilic chronic sinusitis with nasal polyps(non-ECRSwNP) group(63 cases), another seventy cases of patients who underwent nasal septum correction or inferior turbinate hypertrophy were selected as the control group. The nasal mucosa tissue was taken and hematoxylin-eosin(HE) staining was performed on the three groups of specimens; real-time fluorescent quantitative PCR(qRT-PCR) method and immunohistochemistry method were used to determine the PAR-2 and COX-2 mRNA levels and protein expression in tissues; Pearson correlation coefficient method was used to analyze the correlation between PAR-2, COX-2 mRNA levels and Lund-Mackay score. Results:There were a large number of binuclear red-stained eosinophils in the subepithelial mesenchyme of the ECRSwNP group, while fewer eosinophils in the non-ECRSwN group; the percentage of eosinophils in ECRSwNP group was significantly higher than that in non-ECRSwN group(P<0.05). PAR-2 protein was located in the cytoplasm and membrane of tissue mucosal epithelial cells and lower gland cells, while COX-2 protein was mainly located in the cytoplasm and membrane of tissue mucosal epithelial cells, both of which were brown particles; the Lund-Mackay score, PAR-2, COX-2 mRNA levels and protein expression positive rate in the ECRSwNP group and non-ECRSwN group were significantly higher than those in the control group. The Lund-Mackay score, PAR-2, COX-2 mRNA levels and protein expression positive rate in ECRSwNP group were significantly higher than those in non-ECRSwN group(P<0.05); the Pearson correlation coefficient method showed that the levels of PAR-2 and COX-2 mRNA in the tissue samples of ECRSwNP patients were positively correlated with the Lund-Mackay score. And the levels of PAR-2 mRNA and COX-2 mRNA were positively correlated(P<0.05). Conclusion: PAR-2 and COX-2 are abnormally highly expressed in the nasal sinus tissue of patients with ECRSwNP, which can reflect the severity of the disease to a certain extent, and may be used as potential indicators for disease status evaluation and efficacy observation.

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