进展期胃癌血管内皮生长因子C、D表达和淋巴结转移的关系

Expression and Significance of Vascular Endothelial Growth Factor C,D in Advanced Gastric Cancer

目的研究血管内皮生长因子C、D(VEGF-C、D)在进展期胃癌中的表达并探讨其与淋巴结转移的关系。方法应用免疫组织化学EnVision TM两步法对88例进展期胃癌手术病例进行研究,其中淋巴结转移阳性组50例,淋巴结转移阴性组38例。另设正常胃黏膜对照组(n=10)。检测正常胃黏膜和两组进展期胃癌标本VEGF-C、D的表达。结果在进展期胃癌组织中,VEGF-C、D呈阳性表达,阳性表达率分别为52%和62.5%。与正常组比较,胃癌中VEGF-C、D阳性表达率明显升高,差异有统计学意义(均P<0.05)。在伴淋巴结转移的进展期胃癌中,VEGF-C阳性表达率较无淋巴结转移者更高,差异有高度统计学意义(P<0.01);VEGF-D阳性表达率在伴淋巴结转移者与无淋巴结转移者比较,差异统计学意义(P>0.05)。Logistic回归分析发现与胃癌区域淋巴结转移相关的自变量有4个,根据与淋巴结转移的相关联系强度(由OR反映)、促进淋巴结转移的贡献大小(由标准回归系数反映)决定VEGF-C表达对进展期胃癌淋巴结转移贡献最大,相关联系强度较高(P<0.001)。结论进展期胃癌组织中有VEGF-C、D阳性高表达,VEGF-C的表达与进展期胃癌淋巴结转移密切相关,但VEGF-D的表达与进展期胃癌淋巴结转移无关。

Objective To clarify expression of vascular endothelial growth factor C,D（VEGF-C, D） and its relationship with lymph node metastasis in advanced gastric carcinoma. Methods We clas- sified 88 patients with advanced gastric carcinoma which were treated as gastrectomy at department of gastroenterology, into two groups （positive and negative for lymph node metastasis）, while, 10 specimens of normal gastric mucosa were used as the control group. Simultaneously , the expression of VEGF-C and D protein in advanced gastric carcinoma tissues obtained from 88 patients who underwent gastrectomy and in normal gastric tissues obtained from 10 healthy subjects was detected by immuno- histochemistry. Results VEGF-C and D protein were expressed in 52%, 62.5 % of patients, respectively. The VEGF-C and D rate in gastric carcinoma was much higher than that in the control group （P 〈 0.05）. There was significant correlation between the expression of VEGF-C （but not of VEGF- D ）and lymph node metastasis（P 〈0.01）. Logistic regression analysis also showed relationship between VEGF-C expression in gastric carcinoma and lymph node metastasis （P 〈 0. 001 ）. Conclusion The expression of VEGF-C （but not of VEGF-D） closely correlates to lymph node metastasis of advanced gastric carcinoma. The expression positive rate of VEGF - C and D is high in advanced gastric carcinoma.