食管癌及癌旁组织p53蛋白、VEGF及MVD联合检测的临床意义

The determination of p53 protein and VEGF and MVD in esophageal squamous cell carcinoma and adjacent noncancerrous tissue and their relations

目的讨论食管癌及癌旁组织中MVD、VEGF和p53蛋白表达与食管癌临床、病理因素之间的关系,探讨其表达在食管癌患者转移、预后中的作用,并为以食管癌血管生成为靶点的靶向治疗提供理论基础。方法采用免疫组织化学方法,检测30例食管癌患者手术切除标本中癌灶、癌近旁、癌远旁组织的p53蛋白、VEGF的表达,并用FⅧ相关抗原标记、检测MVD。进行统计学分析,探讨其在性别、年龄、临床分期、淋巴结转移、生存率中的关系。结果①癌灶内VEGF阳性染色主要位于癌细胞胞浆内,癌灶p53蛋白阳性染色主要位于癌细胞胞核内,呈棕褐色。肿瘤内血管分布呈明显异质性,在癌组织浸润的边缘较密集,p53蛋白、VEGF、MVD与食管鳞癌关系在性别、年龄、TNM中无显著性差异。但在不同部位、有无淋巴结转移和5年生存率中有显著的统计学差异。②p53蛋白与VEGF表达有显著相关性(P<0.05)。③p53、VEGF表达与MVD相关性具有显著统计学差异。结论在食管鳞癌组织及癌近旁、癌远旁组织中p53蛋白、VEGF、MVD均有不同程度表达,阳性表达率有显著性差异。联合检测可作为食管鳞癌恶性潜能的重要生物学指标,并为食管癌手术切除长度从一个新的角度提供参考及理论基础,并可作为其判断预后的重要生物学指标,并为以血管生成为靶点的靶向治疗提供参考。

Objective To investigate the expression of p53 protein and VEGF, and MVD measurement in esophageal squamous cell carcinoma tissue and 2.0cm,5.0cm adjacent noncancerous tissue from esophageal squamous cell carcinoma to evaluate the relationship between these factors. To explore the role and clinipathological significance of them in esophageal cell squamous carcinoma tissue. Methods Thirty samples were selected.The S-P immunohistochemical method was used to determine the expression of p53 protein and VEGF,MVD was calculated. Results （1）The positive staining of VEGF was brown, and mainly located in cytoplasm.p53 protein was brown,and mainly located in nucleus.MVD was brown.The distribution of positive cells was frequently observed at the invading edge of tumor margins.（2）The positive express of VEGF,P53 and MVD had no significantly difference in different sex,years and TNM stages but had significantly difference in different tissue,lymph node metastasis and 5 years survive rate.（3）The relationship among p53 protein,VEGF and MVD had significantly difference in positive or negative expression of VEGF. Conclusion （1） p53 protein deteetion,VEGF expression and MVD can be considered as biological indicators of malignant potential and prognosis of esophageal carcinoma. （2）Though there were no cancer cell in adjacent noncancerous tissue where p53 protein,VEGF were positive expression,but the change of p53 gene and VEGF gene had happened. （3） Both p53 and VEGF expression may contribute to the tumor neovaseularization,and may be helpful to the understanding of mechanism of angiogenesis in tumor and providing new therapeutics aiming at antiangiogenesis in the future.