血管内皮生长因子在乳腺浸润性导管癌中的表达及意义

Significance and expression of vascular endothelial growth factor in invasive ductal carcinoma of breast.

目的 检测乳腺浸润性导管癌中血管内皮生长因子（VEGF）的表达水平及肿瘤微血管密度（MVD）值，探讨VEGF、MVD水平及与临床病理学特征之间的相关性。方法 采用免疫组化染色法（SP法）分别检测88例乳腺癌患者术后标本中VEGF的表达水平、MVD值以及C-erbB-2表达情况。结果 88例标本中VEGF阳性62例，阳性率为70．45％；淋巴结转移组中VEGF表达水平高于未转移组（P〈0．05）；相对中晚期组（Ⅱb-Ⅲ）中VEGF表达水平高于相对早期组（Ⅰ-Ⅱa）（P〈0．05）；C-erbB-2阳性组中VEGF表达水平高于阴性组（P〈0．05）；随着癌组织学分级的升高，VEGF表达水平也有逐渐升高趋势（P〈0，05）。随着癌组织学分级的升高，MVD值也呈现出逐渐增高趋势（P〈0．01）；MVD值随着VEGF表达水平增高而增高（P〈0．01）。结论 VEGF在乳腺浸润性导管癌的肿瘤血管生成及转移过程中可能发挥重要的调控作用。VEGF和MVD值可作为反映乳腺癌生物学行为的指标之一。以VEGF为靶点的抗血管生成治疗策略有望成为治疗C-erbB-2阳性患者的一条新的途径。

Objective To detect the expression of vascular endothelial growth factor（VEGF） and microvessel density count in invasive ductal Carcinoma of breast to clarify the association of VEGF expression and MVD count with the clinicopathologic features. Methods The expressions of VEGF, C-erbB-2 and MVD count in 88 cases of invasive ductal carcinoma of breast were examined by immunohistochemistry staining （SP-method）. Results Sixtytwo out of the eighty-eight specimens of breast carcinoma showed positive expression of VEGF（ 70.45% ）. The positive rate of VEGF in cases with lymph node metastasis was higher than that without lymph node metastasis （P 〈 0.05 ）. The positive rate of VEGF in stage Ⅱb-Ⅲ was higher than that in stage Ⅰ-Ⅱa （P 〈 0.05 ）. The positive rate of VEGF in C-erbB-2 positive group was higher than that in C-erbB-2 negative group （ P 〈 0.05 ）. Higher expression of VEGF was observed in cases with higher tissue differentiation degree （ P 〈 0.05 ）. Also, significant higher MVD count was observed in cases with higher tissue differentiation degree （ P 〈 0.01 ）. The MVD count increased significantly with the increase of the expression of VEGF （ P 〈 0.01 ）. Conclusion In invasive ductal carcinoma of breast, angiogenesis and metastasis are mediated mainly by VEGF. The expression of VEGF and MVD might be reference predictors for the biological behavior of breast carcinoma. The antiangiogenic therapy which uses VEGF as a target would become a new method to treat patients who are C-erbB-2 positive in the future.