胃癌组织环氧化酶-2和血管内皮生长因子-C表达的意义

Clinical significance of cyclooxygenase-2 and vascular endothelial growth factor-C expression in human gastric carcinoma

目的探讨胃癌组织环氧化酶-2(COX-2)和血管内皮生长因子-C(VEGF-C)表达的意义。方法链霉菌亲生物素蛋白-过氧化物酶连接法检测68例原发性胃癌组织COX-2、VEGF-C、血管内皮生长因子受体-3(VEGFR-3)、白细胞分化抗原CD34表达,计数VEGFR-3阳性的淋巴管密度(LAD)和CD34阳性的微血管密度(MVD),分析COX-2、VEGF-C与胃癌临床病理特征及术后生存率的关系。结果COX-2和VEGF-C表达均与MVD、LAD、淋巴侵犯、TNM分期、不良预后相关;COX-2与淋巴结转移和浆膜侵犯相关;MVD与淋巴结转移和TNM分期相关。COX-2介导的VEGF-C高表达可能通过淋巴管生成促进胃癌淋巴侵犯。结论COX-2和VEGF-C表达均与胃癌淋巴侵犯和不良预后有关,检测COX-2和VEGF-C有助于术后判断淋巴侵犯的程度和预后。

Objective To determine the clinical significance of cyclooxygenase-2 （COX-2） and vascular endothelial growth factor-C （VEGF-C） expression in human gastric carcinoma. Methods Sixty-eight primary gastric carcinoma were immunohistochemically examined for COX-2, VEGF- C, vascular endothelial growth factor receptor-3 （VEGFR-3）, and leukocyte differentiation anti- gen CD34 expressions. Assessments of lymphangiogenic density （LAD） for positive VEGFR and microvessel density （MVD） for positive CD34 were performed. Then, the relationships between COX-2, VEGF-C, clinicopathologic findings of gastric carcinoma, and patients＇ survival time were analyzed. Results The expression of VEGF-C and COX-2A were both related with MVD, LAD, lymphatic invasion, TNM stage and poor prognosis. COX-2 immunoreactivity was also associated with lymphnode metastasis and serosa invasion. Increased MVD was significantly associated with lymphnode metastasis and TNM stage. COX-2-mediated VEGF-C over-expression might promote lymphatic invasion via lymphangiogenesis pathway in patients with gastric carcinoma. Conclusion The data suggest that both COX-2 and VEGF-C expression significantly correlate with lymphatic invasion and poorer prognosis in gastric carcinoma. The detection of COX-2-and VEGF-C is helpful in judging the extent of lymphatic invasion and prognosis.