nm23 VEGF-C及VEGFR-3在大肠癌中的表达及意义

Expression and Clinical Significance of nm23,VEGF-C and VEGFR-3 in Colorectal Carcinoma

目的:探讨nm23、VEGF-C及其受体VEGFR-3在大肠癌中的表达和三者间的相互关系,及其在大肠癌淋巴结转移和肿瘤进展中的意义。方法:采用免疫组化SP法检测97例大肠癌组织和97例正常大肠组织中nm23、VEGF-C及VEGFR-3的表达。结果:1)A、B期大肠癌及无淋巴结转移的大肠癌组织中nm23的阳性表达率分别为68.9%、68.2%,C、D期及有淋巴结转移的大肠癌组织中nm23阳性表达率分别为30.6%、25.8%,A、B期高于C、D期,无淋巴结转移高于有淋巴结转移,差别有统计学意义(P<0.05);VEGF-C阳性表达率在C、D期及有淋巴结转移的大肠癌组织中分别为75.0%、77.4%,在A、B期及无淋巴结转移的大肠癌组织中分别为49.2%、50.0%,两者比较,差别有统计学意义(P<0.05);VEGFR-3在C、D期及有淋巴结转移的大肠癌中的阳性表达率分别为63.9%、67.7%,在A、B期及无淋巴结转移的大肠癌组织中分别为41.0%、40.9%,差别有统计学意义(P<0.05。2)nm23与分化程度、肠壁侵犯深度、有无淋巴结转移及Duckes分期有关(P<0.05),VEGF-C及VEGFR-3与分化程度、淋巴结转移及Duckes分期有关(P<0.05)。3)nm23在正常大肠组织和大肠癌组织中的阳性表达率分别为83.5%、54.6%,差别有统计学意义(P<0.05),VEGF-C在正常大肠组织和大肠癌组织中的阳性表达率分别为29.9%、58.8%,差别有统计学意义(P<0.05),VEGFR-3在正常大肠组织和大肠癌组织中的阳性表达率分别为21.6%、49.5%,两者比较,差别有统计学意义(P<0.05)。结论:nm23与VEGF-C和VEGFR-3在大肠癌中的表达呈负相关关系,nm23基因对大肠癌有抑制作用,VEGF-C和VEGFR-3与大肠癌的侵袭和转移密切相关,三者的联合检测可作为评价大肠癌病情、推测预后及指导治疗的重要参考指标。

Objective： To investigate the expression of nm23, vascular endothelial growth factor C （VEGF-C） and vascular endothelial growth factor receptor 3 （VEGFR-3） in tissues of colorectal carcinoma and to explore the significance of their roles in lymph node metastasis and progression of colorectal carcinoma. Methods： Expression of nm23, VEGF-C and VEGFR-3 were detected in 97 tissue samples of colorectal carcinoma and 97 tissue samples of corresponding normal mucosa with immunohistochemistry. Results： The expression of rim23 was higher in colorectal carcinoma of stages A and B than in stages C and D, and it was higher in colorectal carcinoma without lymph node metastasis than in colorectal carcinoma with lymph node metastasis （P〈0.05）. The expression of VEGF-C and VEGFR-3 was higher in colorectal carcinoma of stages C and D than in colorectal carcinoma of stages A and B, and the expression of both proteins was higher in colorectal carcinoma with lymph node metastasis than in colorectal carcinoma without lymph node metastasis （P〈0.05）. Expression of nm23 was related to the degree of differentiation, depth of invasion, lymph node metastasis and Duke＇s stage （P〈0.05）. The expression of VEGF-C and VEGFR-3 was correlated with the degree of differentiation, lymph node metastasis and Duke＇s stage （P〈0.05）. Significant differences were found in the positive rates of nm23, VEGF-C and VEGFR-3 expression between normal large intestine tissues and tissues of colorectal carcinoma （P〈0.05）. Conclusion： The expression of nm23 was negatively correlated with the expression of VEGF-C and VEGFR-3 in colorectal carcinoma. Combined analysis of nm23, VEGF-C and VEGFR-3 can provide valuable evidence for diagnosis of colorectal carcinoma, estimation of its prognosis, and guidance toward the optimal clinical treatment.