食管癌组织VEGF表达的临床意义

Clinical significance of vascular endothelial growth factor expression on postoperative adjuvant radiotherapy in esophageal carcinoma

目的:探讨血管内皮生长因子(VEGF)蛋白表达对食管癌术后放疗疗效的影响。方法:回顾性研究1999～2001年期间95例有临床随访资料的食管癌术后患者,应用免疫组化方法检测食管癌石蜡切片中VEGF蛋白的表达情况,选取45例根治术后行辅助放疗,选同期单独手术的50例患者作对照,应用Kaplan-Meier法和Cox比例风险模型进行分析。结果:VEGF在食管癌组织中阳性表达主要位于肿瘤细胞胞浆内,其VEGF蛋白表达阳性率为58.9%;VEGF蛋白表达与性别、年龄、病理类型、临床分期之间无明显相关性(P>0.05),但与复发及远处转移呈正相关(P<0.05);在单纯手术组和术后放疗组中VEGF阳性表达和阴性表达的生存率差异有统计学意义(P<0.05);Cox多因素分析结果显示,治疗分组、分期和VEGF表达均为预测食管癌预后的独立指标。结论:VEGF蛋白表达是预后好差的指标之一,VEGF蛋白表达阳性者较阴性者对放疗不敏感,其高表达提示预后不良。

Objective ：To determine the effects of VEGF expression on postoperative adjuvant radiotherapy in esophageal carcinoma. Methods：Ninty-five cases with esophageal careinama who received radical operation were analyzed with followed-up data from 1999 to 2001. Expressions of VEGF in 45 patients with esophageal carcinoma who received radiotherapy after radical operation were determined by immunohistochemical method in contrast with 50 patients with esophageal carcinoma received surgery alone. Kaplan-Meier method and Cox proportional hazard model were used to analyze. Results：The positive expression of VEGF in esophageal carcinoma was observed mainly in cytoplasm of tumor cells. The positive expression rate of VEGF in esophageal carcinoma was 58.9%. The expression of VEGF had no relationship with age, sex, histologic subtype and clinical stages, but had positive relationship with recurrence and distant metastasis. There was significant difference between patients with positive and negative VEGF protein expression in surgery alone and surgery plus radiotherapy group. Cox＇s model analysis showed that theraputic methods, clinical stages, VEGF had separate and significant impacts on prognosis in esophageal carcinoma. Conclusion ： Over expression of VEGF protein suggests a poor prognosis, and has tendency to resisting radiotherapy in esophageal carcinoma.