VEGF-D及其受体Flt-4在胰腺癌中的表达及意义

Expressions of vascular endothelial growth factor D and its receptor Flt-4 in human pancreatic cancer and their significance

目的:探讨血管内皮生长因子D(vascularendothelial growth factor D,VEGF-D)及其受体Flt-4(fms-like tyrosine kinase-4)在胰腺癌中的表达及其与胰腺癌临床病理特征及预后的关系。方法:利用免疫组织化学染色法检测48例胰腺癌组织、32例癌旁胰腺组织及13例正常胰腺组织中VEGF-D及Flt-4蛋白的表达情况,结合临床病理特征及预后对其进行统计学分析。结果:VEGF-D及Flt-4在胰腺癌组织中的表达率显著低于癌旁胰腺组织中的表达率(P<0.05)并显著高于正常胰腺组织中的表达率(P<0.05),胰腺癌组织中有淋巴结转移的VEGF-D及Flt-4的表达率显著高于无淋巴结转移组的表达率(P<0.05),VEGF-D阳性组和Flt-4阳性组患者的中位生存期及1、2、3年生存率均显著低于阴性组(P<0.05)。结论:VEGF-D及Flt-4可促进胰腺癌淋巴结转移的发生,并可作为判断胰腺癌患者预后的预测因素。

Objective： To study the expressions of vascular endothelial growth factor D （VEGF-D） and its receptor fms-like tyrosine kinase-4 （Flt-4） and to determine whether the presence of VEGF-D and Flt-4 was associated with the clinicopathologic characteristics and prognosis of pancreatic cancer. Methods： The expressions of VEGF-D and Flt-4 proteins were examined by immunohistochemical staining in 48 pancreatic cancer tissues, 32 adjacent pancreatic tissues, and 13 normal pancreatic tissue samples. Differences in distribution of VEGF-D or Flt-4 were analyzed using the χ^2 test. Kaplan-Meier survival analysis was used to estimate survival time and log-rank test was used to compare differences in survival time between the patients with or without VEGF-D or Flt-4 expression. Results：Immunohistochemical analysis revealed that the positive staining rates of VEGF-D and Flt-4 in pancreatic cancer tissues were significantly lower than that in para-cancerous tissues （P 〈 0.05 ）, but significantly higher than that in normal pancreatic tissues （P 〈 0.05）. Pancreatic cancer tissues with lymph node metastasis had higher expression of VEGF-D and Flt-4 compared with those without lymph node metastasis （ P 〈0.01 ）. The median survival time and 1-, 2-, 3-year survival rate of VEGF-D-or Flt-4-positive patients were significantly decreased compared with VEGF-D- or Flt-4-negative patients （P 〈 0.05 ）. Conclusion： VEGF-D and Flt-4 may contribute to lymph node metastasis and may serve as a prognostic factor for pancreatic cancer patients.