微血管密度及CD146在小肠间质瘤中的表达及意义

Expression of microvascular density and CD146 in small intestinal stromal tumor and its clinical significance

目的探讨微血管密度(MVD)及CD146在小肠间质瘤中的表达以及与预后的关系。方法用免疫组化二步法检测73例小肠间质瘤中MVD及CD146的表达情况,用CD105标记MVD。另取30例正常小肠组织作为对照。结果小肠间质瘤中MVD为28.00±12.29,CD146高表达率为72.60%(53/73),均明显高于正常小肠组织中MVD及CD146的表达(P<0.05)。小肠间质瘤中CD146高表达组织的MVD为20.35±13.70,高于低表达组织的8.23±9.60,随着CD146表达程度的增加其MVD相应增大,二者呈正相关(r=0.565,P=0.000)。MVD及CD146表达与小肠间质瘤的浆膜浸润、出血坏死、危险度分级、核分裂像多少、直径大小相关(P<0.05),与患者的性别、年龄无关(P>0.05)。MVD高表达(>15)患者的复发转移率为45.16%,高于低表达者的11.90%;MVD高表达者的中位生存时间为34个月,较低表达者的41个月短。CD146高表达患者的复发转移率为33.96%,比低表达者的5%高;CD146高表达者的中位生存时间为30个月,比低表达者的35.5个月短。经Cox回归分析,核分裂像和CD105-MVD是影响小肠间质瘤患者预后的独立危险因素。结论 MVD及CD146可能参与了小肠间质瘤的血管形成过程,二者可以作为判断小肠间质瘤患者预后的有用指标。

Objective To investigate the relationship between expression of microvessel density（MVD） and CD146,and to study their clinical significances in small intestinal stromal tumor.Methods Immunohistochemical staining was used to detect 73 small intestinal stromal paraffin-embedded tumor specimens from patients who were hospitalized in the Union hospital affiliated to Fujian medical university and were treated with surgery during Dec 2001 to Dec 2009.Thirty normal intestinal tissues were taken as control.CD105 was made as a marker of MVD.Results The MVD and high expression of CD146 were 28.00±12.29 and 72.60%（53/73）,which were significantly higher than those in the normal tissues（P0.05）.The MVD in CD146 high expressed tissues was 20.35±13.70,which was higher than that in the low expressed tissues（8.23±9.60）,and the expression of CD146 was increasing by the improving of MVD（r=0.565,P=0.000）.The expression of MVD and CD146 was associated with serous membrane invasion,central necrosis,risk classification,mitotic counts and tumor size（P0.05）,but not with gender and age（P0.05）.The recurrence metastasis rate of small intestinal stromal tumor patients with high expression of MVD（15） was 45.16%,which was significantly higher than that of patients with low expression of MVD（11.90%）;the time of medium survival was short.The recurrence metastasis rate of patients with high expression of CD146 was 33.96%,which was higher than that of patients with low expression of CD146（5%）;the time of medium survival was short.Multivariate analysis revealed that mitotic counts and MVD were independent risk factors.Conclusion MVD and CD146 may participate the angiogenesis of small intestinal stromal tumor.Our results suggest that the evaluation of MVD and CD146 may be useful markers for predicting the prognosis of small intestinal stromal tumor.