胃癌组织中H-ras和VEGF的表达与血管生成的关系及其临床意义

Correlation of H-ras and VEGF expressions with neoangiogenesis in gastric carcinomaand its clinical significance

目的:探讨胃癌组织H-ras表达与血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)表达和血管生成的关系。方法:应用免疫组织化学ABC法对60例胃癌组织进行H-ras、VEGF表达和微血管密度(micro-vasculardensity,MVD)检测。结果:MVD与胃癌病灶的大小、浸润深度、淋巴结转移和TNM分期密切相关,t值分别为-2·18、-3·46、-4·52和-3·85,P值分别为0·040、0·001、0·001和0·004;VEGF亦与胃癌病灶的大小、浸润深度、淋巴结转移和TNM分期密切相关,χ2值分别为12·80、11·49、10·43和11·52,P值分别为0·002、0·001、0·005和0·003。H-ras的表达与胃癌分化和Lauren分型相关,χ2值分别为11·85和8·87,P值分别为0·001和0·003;并与VEGF的表达相关,χ2=10·79,P=0·001。生存分析显示,MVD和VEGF的表达均影响胃癌的预后,但仅MVD是影响预后的独立因素;H-ras的表达对胃癌的预后影响较小。结论:激活的H-ras可上调VEGF的表达,参与胃癌血管生成的调节,并影响胃癌组织的分化。

OBJECTIVE： To investigate the relationship between H-ras, vascular endothelial growth factor （VEGF） expressions and neoangiogenesis in gastric carcinoma. METHODS： The expressions of H-ras, VEGF and microvascular density （MVD） in gastric carcinoma were examined by immunohistochemical staining. RESULTS： There was a close correlation between MVD, VEGF expression and several clinicopathological factors, such as tumor size （t= -2.18, P=0.040, x^2=12.80, P=0.002）, penetrating depth （t=-3.46, P=0.001, ]x^2=11.49, P=0. 001）, lymph node metastasis （t= -4. 52, P=0. 001, x^2 =10.43, P=0. 005） and TNM stage （t=-3.85, P=0.004, x^2=11.52, P=0.003）. H-ras expression in well-differentiated or intestinal type of gastric carcinom was higher than that in poorly-differentiated or diffused type of gastric carcinoma,x^2 = 11.85, P=0.001 or x^2=8.87, P=0.003. Moreover, VEGF expression was associated with the increased H-ras expression,x^2 = 10. 79, P= 0.001. The survival analysis showed that MVD and VEGF expression affected tumor prognosis, but only MVD was an independent prognostics factor. In contrast, H-ras expression had less influence on prognosis in gastric carcinoma. CONCLUSION： The activated H-ras may participate in angiogenesis through VEGF upregulation and influence tumor differentiation in gastric carcinoma.