VEGF的表达及其微血管密度在胃癌组织中的意义

Significance of vascular endothelial growth factor expression and microvessel density in gastric cancer

目的:探讨血管内皮生长因子(VEGF)、CD34的表达与人胃癌多种临床病理因素的关系,分析其在患者预后中的意义.方法:通过免疫组织化学方法回顾性检测169例不同分级分期胃癌组织VEGF的表达,用CD34免疫染色法计数肿瘤微血管密度(MVD),分析VEGF、MVD和胃癌的临床病理因素之间的相关性;并就169例胃癌患者的预后及其相关因素进行统计分析.结果:VEGF的阳性表达率为50.3%,VEGF和CD34为正相关(P=0.0053).VEGF的表达与肿瘤侵袭深度,淋巴结转移,静脉侵犯及TNM分期有关,MVD与原发肿瘤侵犯深度、淋巴结转移、肿瘤大小、静脉侵犯显著相关.VEGF阳性表达者5年无病生存率和总生存率较低(38.8%vs57.1%,P<0.05;35.3%vs54.8%,P<0.01);MVD积分高者5年无病生存率和总生存率也较低(35.3%vs53.9%,23.5%vs49.3%,均P<0.05).结论:VEGF表达与血管生成和肿瘤演进相关,VEGF、MVD及肿瘤部位对胃癌患者是一个有价值的预后因素.

AIM： To detect the correlations among vascular endothelial growth factor （VEGF） expression, microvessel density （MVD） and multiple pathological parameters in gastric cancer and analyze the significance of VEGF expression and MVD in patients with gastric cancer. METHODS： A total of 169 patients with gastric cancer were retrospectively analyzed. The expression of VEGF and CD34 in gastric cancer specimens was detected by immunohistochem-istry. The correlations among VEGF expression, MVD, and prognostic parameters were then analyzed. RESULTS： A positive correlation was noted between VEGF expression and MVD in gastric carcinoma （P = 0.0053）. Both VEGF expression and MVD were associated with tumor invasion, lymph node metastasis and TNM stage.The five-year disease-free survival and overall survival were lower in patients with tumors positive for VEGF than in those with tumors negative for VEGF （38.8% vs 57.1% and 35.3% vs 54.8%, respectively; both P 0.01）. The five-year disease-free survival and overall survival were lower in patients with tumors having high MVD score （ 5） than in patients with tumors having low MVD score （35.3% vs 53.9% and 23.5% vs 49.3%, both P 0.05）. CONCLUSION： VEGF expression is closely associated with tumor angiogenesis and progression in gastric cancer. VEGF expression, MDV and tumor site are valuable parameters for predicting the prognosis of gastric cancer.