血管内皮生长因子在胰腺癌中的表达及其对预后的影响

The expression of vascular endothelial growth factor in pancreatic carcinoma and its effects on prognosis

目的:研究胰腺癌组织中血管内皮生长因子表达与微血管生成和血管侵犯之间的联系,以及其临床意义和对预后的影响。方法:应用免疫组化方法测定36例胰腺癌切除标本中血管内皮生长因子(VEGF,VEGF-C)的表达;通过CD34染色测定其微血管密度(MVD)。结合临床病理和随访资料分析MVD、VEGF、VEGF-C表达与病人预后之间的关系。结果:胰腺癌组织中的MVD为44.04±12.80,VEGF阳性组MVD(49.95±9.57)显著高于阴性组(30.6±18.24)。VEGF的阳性率为69.4%(25/36),发生胰外侵犯组的阳性率为83.3%(20/24),UICC临床分期Ⅲ～Ⅳ期组的阳性率为92.9%(13/14)。VEGF-C的阳性率为55.6%(20/36),淋巴转移组的VEGF-C阳性率为83.3%(10/12),UICC临床分期Ⅲ～Ⅳ组阳性率为85.7%(12/14)。Kaplan-Meier生存分析显示,VEGF、VEGF-C阳性组的预后较差(P<0.05)。结论:胰腺癌的MVD显著升高,VEGF在胰腺癌中的高表达可反映肿瘤微血管生成状况,与胰腺癌的胰外侵犯及UICC临床分期之间有显著意义,故可作为判断预后的依据;VEGF-C与淋巴转移和UICC临床分期相关,也是判断预后的依据。

Objective To investigate the clinical significance of the expression of vascular endothelial growth factor （VEGF） in pancreatic carcinoma, its relationship to angiogenesis and venous invasion, and its effects on prognosis, Methods The expression OF VEGF and VEGF-C was detected by immunohistochemistry in reseeted specimens in 36 patients with pancreatic carcinoma. The microvessel density （MVD） in the specimens was detected by CD34 staining, Results The mean value of MVD was 44.04±12.80 in pancreatic carcinoma specimens. The MVD in VEGF positive group was significantly higher than that in VEGF negative group （49.95±9.57 vs 30.6±18.24）. The positive rate of VEGF in pancreatic eareinoma patients in general, in patients with extrapanereatic infihration, and in UICC stage Ⅲ-IV patients were 69.4% （25/36）. 83.3% （20/24） and 92.9% （13/14）. respectively, The positive rate of VEGF-C in pancreatic carcinoma patients in general, in patients with lymph node metastasis, and in HCC stage Ⅲ-IV patients were 55.6% （20/36）, 83.3% （10/12） and 85.7% （12/14）. respectively. The group with positive VEGF and VEGF-C had a poorer prognosis （P〈0.05）. Conclusions The increased expression of VEGF enhances angiogenesis in panereatie cancer： it is related to extrapanereatie infihration and UICC staging, and could thus be regarded as a prognostic factor. VEGF-C is related to lymph node metastasis and UICC staging, it could also be considered as a prognostic factor.