胃癌组织EGFR和VEGF的表达及其意义

Expression of VEGF and EGFR in gastric cancer undergoing potentially curative surgery and its significance

目的探讨胃癌组织EGFR和VEGF的表达及其与临床病理特征的关系。方法应用免疫组化方法检测正常胃黏膜和胃癌切除标本EGFR和VEGF的表达,并与临床病理参数进行比较分析。结果胃癌组织EGFR和VEGF阳性表达率分别为64.7%和58.8%;正常胃黏膜组织EGFR和VEGF阳性表达率分别为0%和10.0%,差异有统计学意义(P=0.000);EGFR阳性表达与肿瘤分化程度、浸润深度、淋巴结转移、远处转移及临床TNM分期呈显著相关,VEGF阳性表达与肿瘤分化程度、浸润深度、淋巴结转移、远处转移、脉管内癌栓和临床TNM分期呈显著相关(P<0.01和P<0.05)。EGFR表达阳性者有69.7%同时伴有VEGF表达阳性,EGFR和VEGF双阳性表达者的根治切除率仅为30.4%,明显低于阴性表达者(P=0.000)。结论胃癌组织EGFR和VEGF表达上调与肿瘤分化程度、浸润深度、淋巴结转移、远处转移、脉管内癌栓和TNM分期有关,EGFR促进肿瘤血管生长可能通过上调VEGF表达,胃癌组织EGFR和VEGF表达可能成为从同期别病例中甄别靶向治疗获益病例的主要预后指标。

Objective To investigate whether expressions of epidermal growth factor receptor（EGFR） and vascular endothelial growth factor（VEGF） in tumor tissues are related to clinicopathologic parameters,prognostic assessment and identification of patients treated with tailored therapies in gastric cancer.Methods Determination of VEGF and EGFR in 51 gastric cancer samples as well as 20 normal gastric mucosa specimens from non-cancer patients was performed by immunohistochemical staining.The correlation of VEGF and EGFR expressions with the clinicopathologic parameters was investigated in 51 patients undergoing potentially curative surgery.Results The positive rate of EGFR and VEGF expressions was significantly higher in gastric cancer samples than that in normal mucosa specimens（respectively 64.7% vs 0% and 58.8% vs 10.0%,P=0.000）.The positive expressions of EGFR and VEGF were significantly higher in gastric cancers with poorly differentiated adenocarcinomas,distant metastasis,vascular-lymphatic ...更多invasion,pT3/T4,LNM,and TNM-Ⅲ/Ⅳ（respectively,P〈0.01 and P〈0.05）.Nearly 69.7% of EGFR positive tumor cases were stained for VEGF positive in the meantime.The radical resection rate in gastric cancers with both positive EGFR and VEGF was 30.4%,significantly lower than that with both negative EGFR and VEGF（P=0.000）.Conclusions EGFR and VEGF expression up-regulation in gastric tumor is significantly related to cell differentiation,depth of invasion,vascular-lymphatic invasion,LNM and TNM stage.EGFR may be implicated in gastric cancer growth and angiogenesis through up-regulation of VEGF.Expressions of VEGF and EGFR may be crucial prognostic parameters to identify patients in same TNM stage who may benefit from tailored target treatments.