血管内皮生长因子C表达与大肠癌预后的关系

Correlations between the expression of VEGF-C and clinicopathological features and prognosis of patients with colorectal carcinoma

目的：研究血管内皮生长因子 C(VEGF-C)在大肠癌组织中的表达水平及其与大肠癌临床病理特征、微 血管密度(MVD)及预后的关系。方法：抽取1996年1月～1998年1月行结直肠癌根治术且接受正规随访的大肠癌 病例69例；采用 EnVision 免疫组织化学技术检测 VEGF-C 在69例大肠癌及20例正常大肠组织的表达；采用抗 CD34免疫组织化学技术评价大肠癌 MVD；采用 Axioplan 2 Imaging 显微图像分析系统对免疫组织化学染色结果进 行定量。结果：94． 2%(65/69) 大肠癌组织和30%(6/20) 正常大肠组织检测到 VEGF-C 表达，染色定位于肿瘤细胞浆； 大肠癌 VEGF-C 表达显著高于相应正常大肠组织(P＜0． 01) ，且与大肠癌淋巴结转移、MVD 及临床分期显著相关(P＜ 0． 05) ，而与病人年龄(≤68；＞68岁)、性别、肿瘤浸润深度、远处转移、分化程度及肿瘤部位相关性均无统汁学意义； VEGF-C 高表达的病人组总生存率和无病生存率均显著低于 VEGF-C 低表达病人组(P＜0． 05) 。结论：VEGF-C 在大肠 癌中异常高表达，且与大肠癌淋巴结转移、临床分期、无病生存率与总生存率显著相关，可作为大肠癌预后判断标记物。

Objective To evaluate the expression of vascular endothelial growth factor （VEGF）-C in colorectal carcinoma （CRC） and to elucidate its relationship to the clinicopathological features and prognosis in patients with CRC. Methods From Jan 1996 to Jan 1998, 69 patients with pathologically confirmed CRC who received curative surgery and routine follow-up were included in this study. The expression of VEGF-C protein in relation to microvessel density （MVD） in 69 surgical specimens of CRC and in 20 normal coloreetal tissues were examined by the EnVision method of immuno- histochemistry （IHC）. Results The VEGF-C protein expression was detected in the cytoplasm of 94.2% （65/69）of the CRC specimens and 30%（6/20）of the normal specimens. The VEGF-C expression level was much higher in the tumor tissue than that in the corresponding normal tissue （P〈0.01）. The VEGF-C expression level was correlated significantly with the lymphatic invasion （P=0.011）, MDV and clinical staging of CRC （P=0.006）. No significant correlation was found between VEGF-C expression and patients＇ age, gender, depth of invasion, metastasis, tumor differentiation and site of the tumor. Patients with high expression of VEGF-C had shorter overall survival and disease-free survival. Conclusions The VEGF-C expression is up-regulated in CRC and higher expression level of VEGF-C might predict a poorer prognosis in patients with CRC.