宫颈鳞癌组织中血管内皮生长因子表达的临床意义

Clinical significance of vascular endothelial growth factor expression in tumor tissue of cervical squamous cell cancer

目的探讨子宫颈鳞状细胞癌组织中血管内皮生长因子(VEGF)表达的临床意义。方法 对1994年1月-1998年7月就诊、放疗、手术根治并能建立随访关系的宫颈癌患者103例,采取免疫组化S- P法检测宫颈鳞状细胞癌组织中VEGF的表达水平,分析宫颈鳞癌患者复发、转移、生存期以及癌的 分化程度、生长方式的关系。结果宫颈癌组织中VEGF表达的阳性率为55．3％(75／103),在高分化鳞状 细胞癌中VEGF阳性表达率为31．5％(10／32),低分化鳞状细胞癌阳性表达率为60．4％(26／43),未分化鳞 状细胞癌阳性表达率为75％(21／28),分化程度越低,阳性率越高(P<0．01)。生长方式中外生浸润型阳 性表达率为45．1％(35／51),内生浸润型阳性表达率为65．4％(34／52),VEGF阳性随生长方式不同而有显 著性差异(P<0．05)。手术根治患者中有淋巴结转移的VEGF阳性表达率为76．2％(16／21),无淋巴结转 移VEGF阳性表达率为33．3％(3／9)(P<0．05)。VEGF阳性表达者5年内复发率为61．4％(35／57),VEGF阴 性表达者5年内复发率为34．8％(16／46)(P<0．05)。VEGF阳性患者5年生存率为43．8％(25／57),VEGF阴 性患者5年内生存率为69．7％(32／46),两者有显著性差异(P<0．05)。结论宫颈鳞状组织中VEGF表达 与分化程度、生长方式、复发、淋巴结转移及生存期密切相关,VEGF阳性表达者预后较差,检测宫颈 癌组织中VEGF表达水平是判断宫颈癌预后的重要指标。

Objective To study the clinical significance of vascular endothelial growth factor （VEGF） expression in tumor tissue of cervical squamous cell cancer. Methods From Jan. 1994 to Jul. 1998, 103 patients with cervical cancer after diagnosis, radiotherapy and curative resection were chosen to build corresponding interview relationships for case studies, and immunohistochemical technique was employed to detect the level of VEGF expression in cervical squamous cell cancer in order to analyze its relationship with cervical squamous cancer recurrence, metastasis, survival duration, degree of cancer differentiation and growth mode. Restults The positive VEGF expression rate was 55.5%（57/103） in the tissue of cervical cancer, 31.5%（10/32） in highly differentiated squamous cell cancer, 60.4%（26/43） in lowly differentiated squamous cell cancer,75%（21/28） in undifferentiated squamous cell cancer. The lower the degree of differentiation was, the higher the positive rate was（P 〈 0.01）. The positive VEGF expression rate was 45.1%（23/51） in outgrowth invasive cancer, 65.4%（34/52） in in-growth invasive cancer, and there was an apparent difference in different growth modes（P 〈 0.05）. The positive VEGF expression rate was 76.2%（16/21） in curative resection patients with lymph node involvement, and 33.3%（3/9） in patients without lymph node involvement（P 〈 0.05）. The recurrence rate within 5 years in patients with VEGF-positive expression was 61.4%（35/57）, 34.8%（16/46） in patients with VEGF-negative expression（P 〈 0.05）. The survival rate within 5 years in patients with VEGF-positive expression was 43.8（25/57）, 69.7%（32/46） in patients with VEGF-negative expression（P 〈 0.05）. Conclusion VEGF expression in cervical squamous cell cancer has a close relationship with the degree of differentiation, growth modes, recurrence, lymph node involvement, and survival duration. The prognosis of patients with positive VEGF expression is worse than patients with VEGF negative expression. The level of VEGF expression in cervical cancer tissue is an important prognostic indicator for cervical squamous cell cancer.