血管发生对胃癌的发展与预后的影响

The role of angiogenesis in gastric cancer

目的探讨血管发生在胃癌发展和预后中的作用。方法用免疫组织化学染色法检测９８例胃癌标本的微血管计数并研究其与临床病理特征和预后的关系。结果胃癌的微血管数为１２～１１４８支，平均３１７支；女４０５支，男５２７支（Ｐ＜００１）。年龄从少到老，由４２５支增至６０６支（Ｐ＜００５）；胃癌从小长大，其微血管数由３４３增至５１４支（Ｐ＜００１）。浅表型３７６支，最少；隆起型６５５支，最多（Ｐ＜００１）。胃癌从粘膜侵入浆膜下，由２５８支增至５７８支（Ｐ＜００１）；侵入淋巴管，３６３支增至５７５支（Ｐ＜００１）；胃癌转移到淋巴结，其微血管数由４４０支增至５５９支（Ｐ＜００１）；转移到肝肺，４８４支增至７４６支（Ｐ＝００７）。本组全部胃癌患者中，从２０支以下增到６０支以上，其５年生存率由６９％（２４／３５）降到３６％（５／１４）（Ｐ＜００５），根治性切除患者中５年生存率从７３％（２４／３３）减至２９％（５／１７）（Ｐ＜００１）。结论血管发生可能促进胃癌的发展并影响其预后。

Objective To evaluate the role of angiogenesis in the progression and prognosis of patients with gastric cancer. Methods The microvessel count (MVC) was determined using immunohistochemical method in 98 gastric cancer samples and the correlation of MVC with clinicopathological features and prognosis were evaluated. Results MVC ranged from 1 2 to 114 8 and its average was 31 7.The arerage count of microvessel was 40 5 in female, 52 4 in male ( P <0 01). MVC ascended from 42 5 to 60 6 ( P <0 05) as age increased, rose from 34 3 to 59 1 ( P <0 01) as gastric cancers grew larger. Superficial type had a count of 37 6, being the lowest, elevated type showed a count of 65 5, being the highest ( P <0 01). MVC increased from 25 8 to 57 8 ( P <0 01) when gastric cancers invaded into serosa layer, rose from 36 3 to 57 5 ( P <0 01) as carcinomas invaded lymphatic vessel, ascended from 44 0 to 55 9 ( P <0 05) while tumors metastasized to lymph node, increased from 48 4 to 74 6 ( P =0 07) when carcinomas metastasized to liver or lung. As MVC increased from the number less than 20 to more than 60, the 5 year survival rate decreased from 69% (24/35) to 36%(5/14) ( P <0 05) in all gastric cancer patients, this rate also reduced from 73% (24/33) to 29% (5/17) ( P <0 01) in curative resection patients. Conclusion Angiogenesis might promote the progression of gastric cancer and affect the prognosis of gastric cancer patients.