睾丸生殖细胞恶性肿瘤血管生成拟态的研究和预后相关性分析

Vasculogenic Mimicry in Testicular Germ Cell Malignant Tumor and Its Significance for Prognosis

目的：研究睾丸生殖细胞恶性肿瘤（Testicular germ cell malignant tumors，TGCMT）中是否存在血管生成拟态（Vasculogenic mimicry，VM），阐述血管生成拟态的临床意义及相关机制。方法：收集TGCMT组织切片40例临床和预后资料完整，复习切片明确诊断后进行CD34和PAS双重染色，证实肿瘤组织中VM的结构，利用多因素性相关分析阐述VM的临床意义。结果：40例睾丸生殖细胞恶性肿瘤中VM阳性者22例（53．66％）。χ^2检验分析血管生成拟态的阳性率与肿瘤大小、有无转移以及患者的生存状态之间具有差异，P=0．013，P=0．045，P=0．000。Kaplan—Meier生存分析显示有无VM肿瘤患者生存时间差异具有统计学意义，根据Log—rank检验法比较两组间生存曲线有显著性差异（P=0．0127）。Cox比例风险模型分析表明VM是影响TGCMT患者预后的危险因素（P=0．038，OR=4．043）。结论：TGCMT中存在VM，VM是影响TGCMT患者预后的危险因素。

Objective： To observe vasculogenic mimicry in testicular germ cell malignant tumor and to investigate the mechanism and clinical significance of vasculogenic mimicry in testicular germ cell malignant tumors. Methods： Forty cases of testicular germ cell malignant tumor with adequate clinical and pathological data were enrolled. The presence of vasculogenic mimicry was observed by immunohistochemical and histochemical double staining of CD34 and PAS. The clinical significance of vasculogenic mimicry was assessed. Results： VM channels were found in 22 of the 40 cases of testicular germ cell malignant tumor. Analysis using the Chi-sqaure test showed no statistical significance of VM positive rate in patients with different tumor size, metastasis or survival status （P=0.013, P=0.045, and P=0.000）. Kaplan-Meier survival analysis showed that the presence of VM had a negative influence on prognosis （P=0.0127）. Cox＇s proportional hazards model analysis indicated that the presence of VM was significant in predicting patient survival （P=0.038, OR=4.043）. Conclusion： VM exists in testicular germ cell malignant tumor and is a risk factor influencing prognosis. Patients with VM have poorer prognosis than those without VM.