结直肠肿瘤微血管计数与临床病理的相关性

Correlations of microvessel quantitation in colorectal tumors and clinicopathology

目的探明血管生成与结直肠肿瘤的发生、发展中的关系．评估肿瘤微血管计数（ＭＶＤ）与结直肠肿瘤预后的相关性．方法以抗ＣＤ３１单克隆抗体标记显示血管内皮细胞，回顾性对３２例结直肠癌、５例结直肠腺瘤及１０例正常粘膜（对照）蜡块标本进行免疫组化染色，然后在２００Ｘ倍数的显微镜视野下计数每一视野的微血管数，每例计数３个最高值视野，并取其平均数为其ＭＶＤ值．结果正常粘膜ＭＶＤ值为１１±４，腺瘤为２８±１１，癌为５０±２２．正常粘膜与癌比较Ｐ＜００１，腺瘤与癌比较Ｐ＜００５，正常粘膜与腺瘤比较Ｐ＞００５．按癌组织Ｄｕｋｅｓ分期、分化程度及肿瘤大小分别比较ＭＶＤ值示：Ａ，Ｂ，Ｃ期间ＭＶＤ值有递增，但Ｐ＞００５；高分化组与低分化组间有显著差异，Ｐ＜００５；肿瘤＞６ｃｍ与＜６ｃｍ间有差异，但Ｐ＞００５．以ＭＶＤ值高低分组的生存率比较显示，低ＭＶＤ组生存率高，但差别接近显著意义，Ｐ＞００５但Ｐ＜０１０．结论结直肠肿瘤血管形成在肿瘤的恶变、生长、转移等方面是至关重要的；

AIM To evaluate the angiogenesis in colorectal tumorigenesis and to assess the prognostic significance of microvessel quantitation (MVD). METHODS Thirty two large bowel carcinomas, 5 adenomas and 10 normal mucosa (served as controls) were studied. Endothelial cells were immunostained with an anti CD31 mAb. Three microscopic fields (×200) in each case with the highest number of microvessels were counted, the average value of the three fields was used to evaluate the significance of microvessel density (MVD). RESULTS Anti CD31 mAb provided reliable and selective immunostaining of endothelial cells. MVD was 11±4 in normal mucosa, 28±11 in adenomas, and 50±22 in carcinomas (normal versus adenomas, P >0 05; normal versus carcinomas, P <0 01; adenomas or normal versus carcinomas, P <0 05). According to the tumor differentiation and stage, the evaluation of MVD had difference, but not significant. High MVDs were associated with patient shorter survival (0 10> P >0 05). CONCLUSION Angiogenesis is a critical step in colorectal tumorigenesis. MVD can predict prognosis of colorectal cancer patients.