血管内皮生长因子在直肠癌中的表达及其与临床病理的相关性

Expression of vascular endothelial growth factor and the correlation with clinicopathologic factors in rectal cancer

目的研究直肠癌患者术后组织中血管内皮生长因子（vascular endothelial growth factor，VEGF）表达与临床病理因素的相关性。方法回顾性分析直肠癌根治术后有术后病理组织标本的患者118例，其中Ⅰ期26例，Ⅱ期33例，Ⅲ期50例，Ⅳ期9例。采用免疫组化法检测所有病例的组织标本的VEGF表达情况，分析VEGF表达与临床病理因素的相关性。结果118例直肠癌组织中VEGF的阳性表达率是56．8％，Ⅰ～Ⅳ期的表达率分别为53．8％、36．4％、68．0％和77．8％，不同TNM分期之间VEGF表达差异有统计学意义（P=0．018）。N0、N1、N2患者的VEGF表达表达率分别为44．0％、64．8％、76．0％，组间差异有统计学意义（P=0．014），其他临床和病理因素（T分期、性别、年龄、肿瘤距肛缘的距离、癌结节、神经血管浸润、病理类型、分化程度及有无远处转移）与VEGF表达无相关性。结论VEGF在直肠癌中表达率较高，而且在晚期患者中表达率高于早期，淋巴结阳性患者表达率高于阴性患者。提示VEGF是疾病进展的标志，可作为直肠癌的高危因素之一。

Objective To study the expression of vascular endothelial growth factor （VEGF） in the specimens of rec- tal cancer patients after radical resection and the correlation with multiple clinicopatbologic factors. Method A total of 118 rectal cancer patients undergone radical surgery with postoperative pathologic specimens were evaluated respectively, in which 26 patients were in stage I , 33 in stage II , 50 in stage III and 9 in stage IV. The tissue expression of VEGF in all specimens of rectal carcinoma were examined immunohistoehemically. The results obtained were analyzed clinicopatho- logically. Result The positive expression of VEGF in 118 cases was 56. 8%, and was significantly associated with TNM- stage that were 53. 8%, 36. 4%, 68. 0% and 77. 8% in stage I -IV, respectively, among which the difference was significant （P = 0. 018）. VEGF expression in NO, N1 and N2 was 44. 0%, 64. 8% and 76. 0%, respectively, and the difference among groups was significant （P = 0. 014）. No correlation was observed between VEGF positive expression and other elinicopathologic factors concerning tumor location, gender, age, distance from tumor to anal verge, peritumoral nodule, perineural or venous invasion, pathological type, differentiation, or distant metastasis. Conclusion The positive expression of VEGF was associated with TNM-stage and lymphatic metastasis, suggesting that high tumor expression of VEGF indicates the progression of diseases and VEGF may be considered as a high risk factor for rectal cancer.