非小细胞肺癌中VEGF-C、CD44v6的表达及临床意义

Clinical significance of vascular endothelial growth factor C and CD44v6 expressions in human non-small cell lung cancer

目的研究血管内皮生长因子-C(VEGF-C)和细胞粘附因子(CD44v6)在非小细胞肺癌组织中的表达及其与淋巴血道转移和预后的关系。方法回顾分析56例术前未进行化疗和放疗的非小细胞肺癌的切除标本,采用免疫组化SP法检测肺癌组织中VEGF-C和CD44v6的表达,采用χ2检验分析其表达与肺癌生物学行为的关系,采用Kaplan-meier生存曲线及logrank方法检测生存率。结果鳞癌组织中VEGF-C、CD44v6的阳性表达率分别为65.63%(21/32)、56.25%(18/32),腺癌组织中分别为66.67%(16/24)、62.50%(15/24)。VEGF-C及CD44v6的阳性表达与肺癌淋巴结的转移、肺癌的病理分期关系密切(P<0.05),且与肺癌术后发生转移密切相关。VEGF-C、CD44v6阳性表达者3及5年生存率分别为18.79%、7.24%和17.73%、11.04%,阴性表达者为66.23%、59.55%和68.26%、54.33%,两者之间差异显著(P<0.05);VEGF-C与CD44v6阳性表达呈显著正相关。结论联合检测VEGF-C和CD44v6表达对于非小细胞肺癌淋巴血行转移、病理分期、术后转移复发的评估有一定临床意义,可用于指导临床选择正确的综合治疗。

Objective To investigate expressions of vascular endothelial growth factor C（VEGF-C） and CD44v6 in non-small cell lung cancer （ NSCLC） and to explore their association with invasion,metastasis and prognosis of NSCLC. Methods A rapid immunohistochemical method （streptavidin peroxidase,SP） was used to detect VEGF-C and CD44v6 protein expressions in 56 paraffin-embedded resected NSCLC tissues retrospectively. All the patients were initially treated. Results Expression rates of VEGF-C in squamous cell carcinoma and adenocarcinoma were 65. 63% （21/32） and 66. 67% （16/24） respectively. The positiv rates of CD44v6 expression in squamous cell carcinoma and adenocarcinoma were 56. 25% （18 /32） and 62. 50% （15 /24） respectively. The positive expressions of VEGF-C and CD44v6 were significantly correlated with lymph node metastasis and TNM stage （P〈0. 05）,and also with post-operative hematogenous metastasis （P〈0. 05）. The 3-and 5-year survival rates of patients with positive VEGF-C expression were 18. 79% and 7. 24% respectively,whereas they were 66. 23% and 59. 55% in those with negative expression,and there was a significant difference in the survival rate between the two groups （P〈0. 05）. The 3-and 5-year survival rates were 17. 73% and 11. 04% in the CD44v6 positive expression group,and 68. 26% and 54. 33% in the negative expression group,and there was also a significant difference. VEGF-C had a correlation with the positive expression of CD44v6 （P〈0. 05）. Conclusion Detection of VEGF-C and CD44v6 expressions in NSCLC is helpful to evaluate lymph node metastasis,TNM stage and prognosis. It is also helpful to guide post-operative multiple modality therapy.