Ⅱ期结直肠癌组织VEGF-A与MVD检测的临床意义

Clinical significance of VEGF-A and MVD detection in stage Ⅱ colorectal cancer tissue

目的探讨Ⅱ期结直肠癌组织血管内皮生长因子A(VEGF-A)与微血管密度(MVD)检测的临床意义。方法用免疫组化PV6000法检测56例Ⅱ期结直肠癌组织及13例正常组织的VEGF-A表达与MVD,分析其与患者临床病理特征的关系以及对生存的影响。结果(1)肿瘤组织VEGF-A表达和MVD明显高于正常组织(64.3%vs.0,23.69±5.779vs.7.9±1.27;P均=0.000);原发肿瘤>5cm癌组织VEGF-A表达明显高于<5cm者(85.0%vs.52.8%,P=0.034),发生复发或转移患者的癌组织VEGF-A和MVD明显高于未发生复发或转移者(57.1%vs.28.9%,P=0.039;28.94±4.208vs.22.41±5.428,P=0.000);年龄>60岁患者的癌组织MVD明显高于≤60岁患者(27.36±5.658vs.21.67±4.959,P=0.001),低分化患者癌组织MVD明显高于中高分化者(27.65±6.329vs.23.16±5.416,P=0.013);VEGF-A阴性组与弱阳性组及强阳性组MVD值的差异均有统计学意义(21.80±4.60vs.24.51±5.07,P=0.027;21.80±4.60vs.25.79±3.78,P=0.006),VEGF-A弱阳性组和强阳性组MVD值的差异无统计学意义(24.51±5.07vs.25.79±3.78,P=0.666)。(2)56例Ⅱ期结直肠癌患者1、3、5年生存率分别为98.23%、87.37%和75.96%;癌组织VEGF-A表达与患者DFS(χ2=8.570,P=0.014,r=-0.292)和OS(χ2=6.502,P=0.039,r=-0.281)相关,VEGF-A表达越强,DFS和OS越短;癌组织MVD与患者的DFS相关(χ2=6.806,P=0.032,r=-0.213),MVD越高,DFS越短,但是与OS无明显相关性(χ2=1.902,P=0.168,r=-0.022)。结论Ⅱ期结直肠癌组织VEGF-A表达和MVD与患者的临床病理特征有一定的关系,可能是判断预后的重要参考指标。

Objective To study the clinical significance of VEGF-A and MVD detection in stageⅡcolorectal cancer tissue. Methods VEGF-A and MVD in 56 stage Ⅱ colorectal cancer postoperative tissues and 13 normal colorectal tissues were detectd by immunohistochemical technique, the relationship between VEGF-A, MVD and clinicopathological characteristics, prognosis in stage II colorectal cancer patients was analyzed by SPSS16. 0 software. Results （ 1 ） VEGF-A expression and MVD in cancer tissue were obviously higher than in normal tissue（64. 3% vs. 0, P = 0. 000; 23.69 ± 5. 779 vs. 7.9 ±1.27, P = 0. 000）. VEGF-A expression in cancer tissue of patients with different tumor size had statistical difference（85.0% vs. 52. 8% , P =0. 034）, VEGF-A expression in tissue of patients who relapsed or did not finally also had statistical difference（57. 1% vs. 28.9% , P =0. 039）. MVD in tissue of patients with different age and tumor differentiation had statistical difference （27.36 ±5. 658 vs. 21.67 ± 4. 959, P = 0. 001 ; 27.65± 6. 329 vs. 23.16±5.416, P =0. 013）, MVD in tissue of patients who relapsed or did not finally also had statistical difference（28.94 ±4. 208 vs. 22.41 ±5.428, P =0. 000）. MVD in the group of VEGF-A negative and weak positive, strong positive had statistical difference（21.80 ±4. 60 vs. 24. 51 ±5.07, P =0. 027; 21.80±4. 60 vs. 25.79 ±3.78, P =0. 006）. （2） 1-, 3-, 5-year survival rates of 56 stage Ⅱ colorectal cancer patients seperately were 98.23% ,87.37% and 75.96%. The expression of VEGF-A in cancer tissue had relationship with DFS（x^2 = 8. 570, P = 0. 014, r = -0. 292） and OS （X^2 = 6. 502, P = 0. 039, r = - 0. 281 ）, MVD in cancer tissue also had relationship with DFS （X^2 = 6. 806, P = 0. 032, r = -0. 213 ）, but had no statistical relationship with OS （X^2 =1. 902, P = 0. 351, r = - 0. 022）. Conclusion There is a relationship between VEGF-A expression and MVD, they are also related with clinicopathological characteristics and prognosis, and could provide some useful reference in comprehensive therapy of stage Ⅱ colorectal cancer patients.