Дослідження діагностичної інформативності якісного тесту циклооксигенази-2 при пухлинах зовнішніх статевих органів у жінок

Abstract

The article presents the results of diagnostic value the qualitative test of cyclooxygenase-2 (COX-2) in tumors of the external genital organs in women. The objective: to evaluate the expression of the molecular marker COX-2 depending on the clinical, topographic, histological and morphological features of tumors of the external genital organs. Materials and methods. A prospective follow-up of 131 women with external genital tumors was conducted. In all clinical cases, a qualitative COX-2 test was performed. Results. When determining the diagnostic value of a qualitative COX-2 test for FIGO clinical staging, the «chances» (OR) of detecting COX-2 positive in patients increased at stages III (OR – 2.41) and IV (OR – 3.88). During TNM-staging, the reliable value of the qualitative analysis of COX-2 was verified at the T3 stage (78.6%), T4 stage (100.0%), as well as in the presence of Tx (100.0%). In the presence of metastases in the lymph nodes, the number of COX-2-positive clinical cases, depending on the degree of damage to the lymph nodes, increased to 44.4% with N1 (an increase of 1.92 times) compared with 29.3% with N0, reaching 50, 0% at N2 (the probability of metastasis increased by 2.41 times). It was proved that in the absence of distant metastases (M0), the proportion of COX-2-positive cases was 33.1%, and in the presence of (M1) it was 50.0%. The «chances» of distant metastases increased from 1.97 at M0 to 4.0 at M1. Reliable diagnostic value of a qualitative COX-2 test from the degree of differentiation of primary tumors of the external genital organs was established: in the presence of a high degree of differentiation, the detection rate reached 24.5% (OR – 1.0), with a moderate degree – 35.4% (OR – 1.68), in the presence of a low degree of differentiation – 44.0% (OR – 2.60), with undifferentiated tumors – 100.0% (OR – 10.0). When assessing the morphological features of the tumor, the diagnostic informativeness of the qualitative test was confirmed in the presence of undifferentiated cancer in 100.0% of cases (OR – 5.0), adenocarcinomas – in 60.0% of cases (OR – 2.83), malignant melanoma – 40, 0% of cases (OR – 1.25), as well as squamous keratinizing – 32.0% (OR – 1.0) and squamous non-keratinizing cancer – 36.0% (OR – 1.07). Conclusion. For the assessment of localization of the primary tumor, the greatest diagnostic value of the qualitative test was established for total lesion (100.0%, OR-2.0), labia majora pudendi (40.0%, OR-1.29) and vulva (34, 1%, OR – 1.0). Key words: cyclooxygenase-2, qualitative test, diagnostic value, tumors of external genital organs, women.