IGF-Ⅱ、VEGF和MVD在肝细胞癌中的表达及临床意义

Expression of IGF-Ⅱ, VEGF and MVD in hepatocellular carcinoma and the clinical significance

目的探讨胰岛素样生长因子Ⅱ(IGF-Ⅱ)、血管内皮生长因子(VEGF)以及CD34抗体标记肿瘤微血管密度(MVD)在人原发性肝细胞癌(HCC)中的表达水平、临床意义及其相关性。方法应用免疫组织化学法检测50例HCC患者手术切除肝癌组织和癌旁组织标本中IGF-Ⅱ、VEGF和CD34的表达,分别对IGF-Ⅱ和VEGF表达进行积分光密度值(IOD)测定,对CD34阳性组织进行MVD计数,并结合临床资料进行统计学分析。结果 IGF-Ⅱ在HCC肝癌组织、癌旁组织和正常肝组织中的IOD值分别为55940.00±44570.41、83688.81±64460.15和0;VEGF的IOD值分别为37315.79±27315.09、38181.70±33391.02和2528.96±1445.21。肝癌组织、癌旁组织与正常肝组织相比,IGF-Ⅱ和VEGF的IOD值差异均有统计学意义(P<0.05);但肝癌组织与癌旁组织比较,IGF-Ⅱ的IOD值差异有统计学意义(P<0.05),而VEGF的IOD值差异无统计学意义(P>0.05)。HCC肝癌组织MVD值为42.10±20.63,癌旁组织MVD值为28.96±8.55,正常肝组织MVD值为17.70±9.67,三者差异有统计学意义(P<0.01)。IGF-Ⅱ、VEGF和MVD的表达都与淋巴结或肝内转移、病理分化程度有关(P<0.05),而与其他因素无关(P>0.05);且IGF-Ⅱ与肿瘤大小有关(P<0.05)。IGF-Ⅱ和VEGF共阳性表达组MVD值为44.24±21.22,高于IGF-Ⅱ和VEGF共阴性表达组MVD值(19.25±14.45),差异有统计学意义(P<0.05)。且IGF-Ⅱ在HCC肝癌组织中的表达与VEGF呈明显正相关(P<0.01),随着IGF-Ⅱ强度的增加,VEGF表达增强。结论 IGF-Ⅱ在HCC中表达显著增加,并可能诱导VEGF和MVD的过表达,且与HCC的侵袭性生物学行为密切相关。

Objective To explore the expression levels of insulin-like growth factor Ⅱ（IGF-Ⅱ ）, vascular endothelial growth factor （VEGF） and CD34 antibody to tumor microvessel density （MVD） in human hepatocellular carcinoma （HCC）, and to explore the clinical significance and the correlation with HCC. Methods The expression of IGF- Ⅱ, VEGF and CD34 were detected by immunohistochemistry in 50 cases of HCC tissues and the adjacent tissues. The intensity of IGF- Ⅱ and VEGF expression were measured by integrated optical density （ IOD）, and CD34-positive samples were counted with MVD. The clinical data were statistically analyzed. Results The IOD of IGF- Ⅱ in the groups of HCC, HCC-adjacent tissue and normal liver tissue were 55 940.00 ±44 570.41,83 688.81 ± 64 460. 15 and zero, respectively. The IOD of VEGF in these three groups were 37 315. 79 ± 27 315.09, 38 181.70 ±33 391.02 and 2 528.96 ±1 445.21, respectively. The IOD of IGF- Ⅱ and VEGF in HCC and the adjacent tissue were significantly higher than that in normal liver tissue（P 〈0.05）. The IOD of IGF-Ⅱ between HCC and HCC-adjacent tissue was significantly different （ P 〈 0. 05 ）, while the IOD of VEGF between these two groups was not significantly different（ P 〉 0.05）. MVD in HCC, HCC-adjacent tissue and normal liver tissue were 42.10 ± 20.63, 28.96 ± 8.55 and 17.70 ±9.67 respectively, and the differences were significant （P 〈0.01 ）. Expression of IGF-Ⅱ , VEGF and MVD were correlated with the degree of histological differentiation of HCC and metastasis of lymph node or liver （P 〈 0. 05）, but not related to other factors （ P 〉 0. 05 ）. IGF- Ⅱ was related to tumor size （ P 〈 0.05 ）. MVD in the cases with positive IGF-Ⅱ and VEGF were 44.24 ± 21.22, which was higher than that with negative IGF- Ⅱ and VEGF （ 19.25 ± 14.45 ）, and the difference was statistically significant （P 〈0.05）. IGF- Ⅱ in HCC tissue was significantly correlated with VEGF （P 〈0.01 ）, and the expression of VEGF was increased with the increasing intensity of IGF-Ⅱ. Conclusions Expression of IGF- Ⅱ in HCC was significantly increased, which may induce overexpression of VEGF and MVD. The aggressive biological behavior of HCC is closely related to the enhanced expression..