胰腺癌中内皮抑素表达与微血管密度测定的意义

Expression of endostatin and MVD in pancreatic carcinomas

目的探讨内皮抑素(endostatin)表达与微血管密度(MVD)在胰腺癌发生、发展中的作用及对预后的影响。方法采用免疫组化SP法检测endostatin、MVD在50例胰腺癌、10例正常胰腺组织中的表达,分析它们与胰腺癌临床病理参数及患者生存率的关系。结果(1)endostatin在正常胰腺组织、胰腺癌中的阳性表达率分别为40%、78%,差异有显著性(P<0.05),其表达强度与胰腺癌临床分期及淋巴结转移相关(P<0.01,P<0.01),与性别、年龄、肿瘤部位、肿瘤直径及分化程度无关。(2)胰腺癌中MVD均值(33.74±11.44),明显高于正常胰腺组织(17.40±4.74)(P<0.01),Ⅲ～Ⅳ期胰腺癌MVD均值(40.89±10.33)高于Ⅰ～Ⅱ期(25.35±5.38)(P<0.01),淋巴结转移组MVD均值(40.84±10.70)高于未转移组(26.64±6.90)(P<0.01),与性别、年龄、肿瘤部位、肿瘤直径及分化程度无关。(3)生存分析提示endostatin及MVD与胰腺癌的预后有关(P<0.01)。结论endostatin及MVD在胰腺癌发展中起重要作用,可对胰腺癌恶性程度的判定和预后评估提供有效的依据。

Purpose To study the effects of the expression of endostatin and MVD on progression and prognosis in pancreatic carcinomas. Methods The expression of endostatin and MVD were studied by S-P immunohistochemistry in 50 cases of pancreatic carcinomas and 10 cases of normal pancreas tissues. Their relationship with clinicopathological features and survival rate was also investigated. Results (1) The expression ratios of endostatin in normal pancreas tissue and in pancreatic carcinoma were 40% and 78% respectively,showing significant difference (P<0.05).The endostatin expression intensity was associated with clinical stages and metastasis of lymph nodes (P<0.01,P<0.01),but was not associated with sex,age,location of tumor,size of tumor and histological grade. (2) The mean MVD in pancreatic carcinomas and in normal tissues was 33.74±11.44 and 17.40±4.74 respectively,showing significant difference(P<0.01).The mean MVD in stage Ⅲ~Ⅳ(40.89±10.33) was much higher than in stageⅠ~Ⅱ(25.35±5.38)(P<0.01),and the mean MVD was higher in those with metastasis of lymph node (40.84±10.70)than those without metastasis(26.64±6.90)(P<0.01),but had no significant difference among sex,age,the location of tumor,size of tumor and histological grade.(3) The analysis of single factor revealed that the expression of endostatin and MVD was significantly related with the prognosis of patients(P<0.01,P<0.01). Conclusions It is suggested that endostatin and MVD play important roles in progression and prognosis of pancreatic carcinoma. Detection of these proteins is useful for diagnosis,prognosis determination and treatment of pancreatic carcinomas.