血管内皮生长因子-C、D对大肠癌的预后判断价值

Value of VEGF-C and VEGF-D in predicting the prognosis of colorectal carcinoma

目的观察血管内皮生长因子（VEGF）-C和VEGF-D在大肠癌中的表达，探讨其在大肠癌预后判断中的价值。方法抽取1996年1月至1998年1月于我院行大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和VEGF-D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微血管密度（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分析。结果69例患者平均随访（68．96±32．79）个月，中位随访87个月，108个月无病生存率与总生存率分别为51．44％和60．07％。大肠癌VEGF-C和VEGF-D表达显著高于相应正常大肠组织（P〈0．01）；VEGF—C表达与大肠癌淋巴结转移及临床分期显著相关（P〈0．05）；VEGF-D表达与大肠癌患者年龄（≤68：〉68岁）、淋巴结转移及肿瘤浸润深度显著相关（P〈0．05）。VEGF—C和VEGF-D表达与大肠癌MVD显著相关（P〈0．05）；VEGF—C和／或VEGF—D高表达的大肠癌患者组总生存期和无病生存期均显著低于VEGF—C和／或VEGF—D低表达患者组（P〈0．05）。结论VEGF—C和VEGF—D在大肠癌中异常高表达，且与大肠癌淋巴结转移、临床分期、无病生存与总生存率显著相关，可作为临床大肠癌预后判断标志物。

Objective To evaluate the value of vascular endothelial factor （VEGF） -C and -D in predicting the prognosis of colorectal carcinoma （CRC）. Methods Between Jan. 1996 and Jan. 1998,in 69 patients with pathologically confirmed CRC who received radical surgery and routine follow-up and 20 cases of normal colorectal tissues, the expression of VEGF-C and VEGF-D protein in relation to microvessel density （MVD） was examined by immunohistochemistry. Results All the 69 patients were followed up and the disease-free survival （DFS） and the overall survival （OS） at 108 months were 51.44% and 60.07% respectively. The VEGF-C expression level was significantly correlated with the lymphatic invasion （P 〈 0.05 ） and clinical stage of CRC （P 〈 0.01 ）. The expression of VEGF-D protein was significantly correlated with the patients＇age （P 〈 0.05 ）, depth of tumor invasion （P 〈 0.05）, and lymphatic invasion （P 〈 0.05）. The VEGF-C and VEGF-D expression was significantly correlated with MVD and both the OS1 and DFS were significantly shorter in patients with higher VEGF-C and/or VEGF-D expression level. Conclusion Higher expression of VEGF-C and VEGF-D which was closely correlated with lymphatic involvement and poorer prognosis might be used as prognosis indicators for CRC.