下咽鳞癌中uPA的表达和微血管密度与肿瘤侵袭转移的关系

Expression of uPA and microvessel density correlate with invasion and metastasis of hypopharyngeal squamous cell carcinoma

目的检测尿激酶纤溶酶原激活剂(uPA)在下咽鳞状细胞癌组织及癌旁正常黏膜中的表达以及CD34抗体标志的微血管密度(MVD)的差异,探讨其与下咽癌侵袭转移的关系。方法应用免疫组织化学SP法检测60例下咽癌组织及20例下咽部癌旁正常黏膜组织中uPA蛋白的表达及以CD34抗体标志的微血管密度。结果 uPA蛋白在下咽鳞癌组织中的表达率为78.33%(47/60),明显高于癌旁正常黏膜组织中的表达(P<0.001),uPA蛋白的表达与其临床分期、病理分化程度及淋巴结转移呈显著相关关系(P<0.05);MVD计数与肿瘤的临床分期、病理分化程度及淋巴结转移呈显著相关关系(P<0.05或0.01);两者与患者发病年龄及肿瘤原发解剖分区均无明显相关性;下咽癌组织中MVD计数与uPA的阳性表达呈正相关关系(r=0.561,P<0.01);uPA阳性并MVD高表达组的淋巴结转移率为90.91%(20/22),明显高于uPA阳性并MVD低表达组(52.00%)及uPA阴性MVD低表达组(30.77%)(2χ=9.538,P<0.05)。结论 uPA蛋白的高表达促进了肿瘤新生血管的生成,活跃的新生血管生成和uPA蛋白的高表达与下咽癌的侵袭及颈部淋巴结转移密切相关,uPA高表达且MVD计数高的下咽癌患者发生肿瘤浸润及颈淋巴结转移的风险明显增高。uPA的表达强度及MVD的计数值可作为判断下咽鳞状细胞癌生长、浸润及转移能力的重要指标。

Objective To explore the difference between expressions of the urokinase-type plasminogen activator （uPA） and microvessel density （MVD） in cancer tissue and adjacent normal tissue of hypopharyngeal squamous cell carcinoma （HSCC） and to study their correlation with invasion and metastasis of HSCC. Methods Expressions of uPA and MVD of 60 patients with HSCC and 20 cases of paraneoplastic tissues were detected with SP immunohisto- chemical staining. Results The positive expression rate of uPA in patients with HSCC was 78.33%, which was significantly higher than that in paraneoplastic tissues （ P 〈 0. 001 ）. uPA positive expression was closely correlated with clinical stage, pathological differentiation and lymph node metastases of hypopharyngeal carcinoma （ P 〈 0.05 ）. The MVD number was also correlated with clinical stage, pathological differentiation and lymph node metastases of hypo- pharyngeal carcinoma （ P 〈 0.05 or 0.01 ）. Neither was significantly correlated with patient age and primary anatomic area of HSCC. Expression of uPA had a positive correlation with MVD（ r = 0. 561, P 〈 0.01 ） in patients with HSCC.The cervical lymph node metastatic rate in patients with uPA positive-expression and high MVD value was 90.91% （20/22）, which was significantly higher than that in patients with uPA positive-expression but low MVD value （52.00%）, and that in patients with uPA negative-expression and low MVD value （ 30.77% ） （X2 = 9. 538, P 〈 0.05 ）. Conclusion Active angiogenesis and uPA positive-expression are closely correlated with invasion and metastasis of HSCC. HSCC with uPA positive-expression and high MVD value are susceptible to invasion and cervical lymphatic metastasis. Therefore, uPA and the MVD number may be used as effective indices to evaluate the possibility of invasion and metastasis of HSCC.