VEGF及其受体Flt-1、KDR在鼻咽癌组织中的表达及意义

Expression and Clinical Significance of VEGF and Its Receptors Flt-1 and KDR in Nasopharyngeal Carcinoma

背景与目的:VEGF及其受体Flt-1、KDR在肿瘤血管生成及肿瘤进展中发挥关键作用。本研究探讨鼻咽癌组织中VEGF、Flt-1和KDR表达与鼻咽癌患者临床特征及预后的关系。方法:用免疫组织化学的方法检测127例鼻咽癌标本中VEGF、Flt-1和KDR的表达情况,用SPSS10.0软件分析这三种蛋白表达的相关性、与临床特征的关系以及对患者总生存的影响。结果:VEGF、Flt-1和KDR分别表达于66.9%(85/127)、90.6%(115/127)和88.2%(112/127)的鼻咽癌组织。鼻咽癌组织中VEGF表达与Flt-1和KDR表达呈正相关(r=0.292,P<0.01;r=0.287,P<0.01),Flt-1表达与KDR表达呈正相关(r=0.723,P<0.01)。VEGF蛋白的表达与原发肿瘤的侵犯范围、淋巴结转移、临床分期有关(P=0.04,P<0.01,P=0.02),KDR蛋白表达也与原发肿瘤的侵犯范围有关(P=0.03);三种蛋白表达均与肿瘤局部复发和/或远处转移(P<0.01,P<0.01,P<0.01)、总生存不佳有关(P<0.01,P<0.01,P<0.03)。Cox多因素相关分析显示,年龄>50岁和VEGF阳性为不良预后因素(P<0.01,P<0.01)。结论:VEGF及其受体Flt-1、KDR在鼻咽癌中广泛表达,与鼻咽癌患者的临床特征和预后关系密切。

BACKGROUND ＆ OBJECTIVE： Vascular endothelial growth factor （VEGF） and its receptors fms-like tyrosine kinase-1 （Flt-1） and kinase insert domain containing receptor （KDR） play critical roles in angiogenesis and tumor progression. This study was to explore the correlations of VEGF, Flt-1 and KDR expression to clinical features and prognosis of nasopharyngeal carcinoma （NPC） patients. METHODS- Immunohistochemistry was adopted to detect the expression of VEGF, Flt-1, and KDR in 127 specimens of NPC. SPSS statistical software was used to analyze their correlations to clinical features and prognosis of NPC patients. RESULTS： The positive rates of VEGF,Flt-1 ,and KDR were 66.9%,90.6%,and 88.2% in the NPC specimens. The expression of VEGF was positively related to the expression of Flt-1 and KDR （r=0.292, P〈0,01; r=0.287, P〈0.01）. The expression of Flt-1 was positively related to the expression of KDR （r=0.723, P〈0.01）. VEGF expression was related to primary tumor site, lymph node metastasis, and clinical stage （P=0.04, P〈0.01, P=0.02, respectively）; KDR expression was related to primary tumor site （P=0.03）; all of them were related to local recurrence and/or distal metastasis （P 〈0.01, P 〈0.01, P =0.01, respectively）, and poor overall survival （P〈0.01, P=0.01, P=0.03, respectively）, Cox multivariate analysis showed age of more than 50 years and positive VEGF expression were independent prognostic factors （P〈0.01, P〈0.01 ）. CONCLUSION： VEGF, Flt-1, and KDR are widely expressed in NPC tissues, and are positively related to clinical features and prognosis of NPC patients.