类肝素酶-1和血管内皮生长因子在嗜铬细胞瘤中的表达及其相关性

Expression and correlation of Heparanase-1 and vascular endothelial growth factor in pheochromocytomas

目的通过检测类肝素酶-1(HPA)、血管内皮生长因子(VEGF)在良、恶性嗜铬细胞瘤中的表达情况,探讨HPA、VEGF能否成为预测恶性嗜铬细胞瘤的指标,并阐明二者间的关系。方法选取1986年10月～2006年8月住院经手术治疗,且具有完整的临床、病理和随访资料的嗜铬细胞瘤患者存档石蜡标本38例,其中良性嗜铬细胞瘤21例,恶性嗜铬细胞瘤17例。恶性嗜铬细胞瘤组中首次手术确诊为嗜铬细胞瘤后随访28～179个月;良性嗜铬细胞瘤组中首次手术确诊为嗜铬细胞瘤后随访93～264个月。另取20例因良性肾疾患行肾切除时获取的同侧正常肾上腺组织作为对照组。采用免疫组织化学技术,检测良、恶性嗜铬细胞瘤及20例正常肾上腺髓质组织中HPA和VEGF的表达情况。结果HPA在恶性嗜铬细胞瘤中高表达(76.47%),在良性嗜铬细胞瘤中表达较低(28.57%),在正常肾上腺髓质组织中无表达,恶性嗜铬细胞瘤组与良性嗜铬细胞瘤组及恶性嗜铬细胞瘤组与正常肾上腺髓质组织组之间HPA的表达有显著性差异(P<0.05)。VEGF在恶性嗜铬细胞瘤中呈高表达,阳性率为82.40%,在良性嗜铬细胞瘤和正常肾上腺髓质组织中的阳性率分别为23.80%、5.00%,VEGF在恶性嗜铬细胞瘤中的表达与在良性嗜铬细胞瘤和正常肾上腺髓质组织中的表达有显著性差异(P<0.05)。在嗜铬细胞瘤中HPA与VEGF的表达呈正相关。结论HPA和VEGF有望成为预测恶性嗜铬细胞瘤的指标。

Objective To detect the expression of Heparanase-1 （HPA） and vascular endothelial growth factor （VEGF） in benign and malignant pheoehromocytomas, to analyse the value of HPA and VEGF as marker for malignant pheochromocytomas, and to investigate the relationship between HPA and VEGF. Methods Tissue specimens were obtained in operations performed in Ruijin Hospital from 1986-2006. There were 38 pheochromocytomas （including 21 benign and 17 malignant） and the clinical and pathological data were available. The malignant groups follow-up ranged from 28 to 179 months. The benign groups follow-up ranged from 93 to 264 months. Normal adrenal glands were from 20 patients undergoing nephrectomy for benign renal tumor. Immunohistochemical technology was performed to detect the HPA and VEGF in all patients. Results Strong HPA expression was found in malignant pheochromocytomas （76.47%）, whereas weak expression in benign pheoehromocytomas （28.57%） and no expression in normal adrenal medulla immunohistochemically. There was statistical difference between malignant and benign groups, and between malignant group and normal adrenal medulla group （P〈0.05）. Strong VEGF expression was found in malignant pheochromocytomas （82.40%）, whereas weak expression in benign pheochromocytomas （23.80%） and in normal adrenal medulla （5.00%） respectively. There was statistical difference between malignant and benign group, also between malignant group and normal adrenal medulla group （P〈0.06）. There was positive relationship between HPA and VEGF in pheochromocytomas. Conclusion HPA and VEGF may become the predictor markers for malignant pheochromocytoma.