VEGF-D在非小细胞肺癌组织中的表达及与淋巴管生长和淋巴转移的关系

Expression of Vascular Endothelial Growth Factor D and Its Relationship with Lymphangiogenesis and Lymph Node Metastasis in Non-small Cell Lung Cancer

目的:对非小细胞肺癌及正常肺组织中血管内皮生长因子-D(VEGF-D)的表达进行检测,旨在探讨VEGF-D在非小细胞肺癌(NSCLC)组织中的表达特点及与NSCLC相关临床病理因素之间的关系,并探讨VEGF-D在NSCLC淋巴管生成及淋巴结转移中的作用和可能机制。方法:采集NSCLC标本62例及正常肺组织10例,应用免疫组化SP法检测VEGF-D在组织中的表达,应用D2-40标记淋巴管内皮细胞以计数淋巴管密度(LVD)。结果:NSCLC组VEGF-D表达阳性率显著高于正常肺组织组(P=0.000)。VEGF-D表达阳性率在不同性别、年龄、病理类型、肿瘤大小之间差异无统计学意义。在有无淋巴结转移及不同临床分期之间差异有统计学意义(P=0.005,P=0.000)。NSCLC组LVD高于正常肺组织组(P=0.000);有淋巴结转移组LVD高于无淋巴结转移组(P=0.006);相关分析证实LVD 同淋巴结转移范围呈正相关(r=0.379,P=0.002)。随VEGF-D表达强度的差异,各组LVD存在差异,各阳性组均高于阴性组,相关分析证实VEGF-D蛋白表达强度与LVD呈正相关(r=0.437,P=0.000)。结论:淋巴管密度是NSCLC淋巴转移的重要影响因素,VEGF-D参与了NSCLC的淋巴管生成,从而促进NSCLC的淋巴管侵袭和局部淋巴结转移,是评估预后和制定治疗措施的重要指标。

Objective： To assess the expression of vascular endothelial growth factor D （VEGF-D） protein, to analyze its correlation with clinicopathological factors, and to investigate the possible mechanisms of lymphangiogenesis and lymph node metastasis in non-small cell lung cancer （NSCLC）. Methods： The protein expression of VEGF-D and D2-40 was detected in 62 paraffin sections of NSCLC and 10 normal lung tissues using immunohistochemistry. Lymphatic vessel density （LVD） and VEGF-D expression rate were assessed and their relationship was analyzed. Results： The positive rate of VEGF-D in the NSCLC group was significantly higher than that in the normal lung tissue group （P=0.000）. No correlation was found between the positive rate of VEGF-D expression and gender, age, histological type, or tumor diameter. Correlations were found between VEGF-D expression and lymph node metastasis （P=0.005） and between VEGF-D expression and TNM stage （P=0.000）. LVD in the NSCLC group was significantly higher than that in the normal lung tissue group （P=0.000）. LVD in the positive lymph node metastasis group was significantly higher than that in the negative lymph node metastasis group （P=0.006）. A positive correlation was found between LVD and lymph node metastasis zone （r=0.379, P=0.002）. LVD in the positive VEGF-D group was significantly higher than that in the negative VEGF-D group （P=0.000）. A positive correlation was found between the expression of VEGF-D and LVD （r=0.437, P=0.000）. Conclusion： Lymphangiogenesis is a significant factor in tumor lymphatic metastasis. VEGF-D may mediate lymphatic metastasis of NSCLC by inducing lymphangiogenesis and may serve as a prognostic indicator.