喉及下咽部鳞状细胞癌中血管内皮生长因子-c及其受体FLT-4表达与淋巴结转移的相关研究

The expression and role of VEGF-C and its receptor FLT-4 in laryngeal and hypopharyngeal squamous cell carcinoma metastasis

目的:研究喉及下咽部鳞状细胞癌组织中血管内皮生长因子C(VEGFC)及其受体VEGFR3(FLT4)的表达情况,以及它们在肿瘤淋巴转移、微转移中的作用和意义。方法:采用免疫组织化学SP法及图像分析技术,检测49例喉及下咽部癌组织中VEGFC、FLT4及淋巴结中VEGFC蛋白表达和相对含量。结果:喉及下咽部癌组织中VEGFC的表达与病理分级密切相关(均P<0.05),与淋巴结转移之间存在相关关系(均P<0.05),与临床T分期无关。FLT4表达与VEGFC阳性表达呈同向性改变,与淋巴结转移相关(均P<0.05);喉及下咽部癌组织中,FLT4阳性脉管数与病理分级及临床T分期差异无统计学意义(均P>0.05)。喉及下咽部癌组织中淋巴结微转移组,VEGFC、FLT4表达与无转移组之间的差异无统计学意义(P>0.05)。结论:VEGFC在喉及下咽部癌组织中,通过其特异性受体FLT4导致淋巴管增生,促进肿瘤淋巴转移,从而影响患者的预后;检测VEGFC、FLT4,对肿瘤诊断、判断患者预后具有重要临床价值。

Objective：To investigate the expression of VEGF-C and its receptor FLT-4 in laryngeal and hypopharyngeal squamous cell carcinoma,and to analyse its role in lymphatic metastasis and mierometastasis. Method： Forty-nine cases postoperative specimens verified by histopathology were studied. The expression of VEGF-C, FLT-4 were detected with immunohistoehemieal SP method,image analysis method. The elinieopathologieal param eters of tumor were compared with the immunohistoehemieal results of VEGF C and FLT-4, followed by the further analysis on the relationship between VEGF-C/FLT-4 expression and lymph nodal metastasis or mierometastasis. Result：There was a statistical correlation between the expression of VEGF-C and grades of pathological differentiation in laryngeal and hypopharyngeal squamous cell carcinoma. Moreover there was also a statistical correlation between the expression of VEGF-C and lymph node metastases. But no correlation was observed between the expression of VEGF-C and clinical T grades. The statistical correlation also existed between VEGF-C and FLT-4 expression in laryngeal or hypopharyngeal tumors. There was a significant difference of expression of FLT-4 in laryngeal and hypopharyngeal tumours with positive and negative lymph node metastases. No eorrelation was observed between FLT-4 and grades of pathologieal differentiation or elinieal T grades. There was no statistieal eorrelation between the expression of VEGF-C/FLT-4 and nodal mierometastasis （ P〉0.05）. Conclusion： VEGF-C and its reeeptor FLT-4 play an important role in the lymphatie metastasis of laryngeal and hypopharyngeal squa mous eell eareinoma. VEGF-C/FLT-4 may be a useful biologieal marker to foresee the eervieal lymph node metastasis and prognosis.