微血管计数和侵入在肾细胞癌中的表达及意义

Expression and Significance of Microvessel Count and Microvascular Invasion in Renal Cell Carcinoma

目的探讨肾细胞癌(RCC)中微血管计数和微血管侵入情况与肾癌病理分期及术后发生转移的关系。方法采用Ⅷ因子和CD34两种标记染色方法检测88例RCC组织标本中微血管计数和微血管侵入情况,回顾性分析其与患者术后病理分期及是否发生转移的关系。患者随访4年以上,分为无复发转移组和复发转移组。结果用Ⅷ因子相关抗原标记下对RCC组织标本的微血管进行计数,术后4年无复发转移组和复发转移组中平均微血管数量分别为52.3和96.6,二者比较差异有统计学意义(P<0.01)。无复发转移组有微血管侵入者仅占总数42.3%,复发转移组中有微血管侵入者占76.5%(P<0.01);CD34标记下两者比例分别是47.1%和18.3%(P<0.05)。结论微血管计数和微血管侵入对预测RCC患者术后发生复发转移有参考意义,对于较易发生转移或复发的患者,术后应加强随访并考虑及早进行靶向治疗或其他辅助治疗。

Objective To investigate the relationship between tumor angiogenesis,microvascular invasion and the pathological staging,subsequent development of metastatic disease in patients who were undergone surgery for renal cell carcinoma（RCC）.Methods Immunohistochemical method was used to detect Factor Ⅷ and CD34 which decorated endothelial cells in order to assess microvessel count and microvascular invasion and their relevance for developing metastatic disease in 88 cases of RCC.A retrospective analysis of the pathological staging and the development of metastatic disease was made.Patients was taken a follow-up visit of more than 4 years and divided into two groups：recidivation group and unrecidivation group.Results When Factor Ⅷ-related antigen staining was used,we found that the microvessel count correlated with the development of metastatic disease,with a mean count of 52.3 and 96.6 for patients who had non-developed and developed metastatic disease（P 0.01）,respectively.We also found that microvascular invasion correlated with the development of metastatic disease.It was demonstrated that 76.5% of patients who developed metastatic disease versus 42.3% of patients with no evidence of metastasis with Factor Ⅷ staining（P 0.01） were positive,and 47.1% versus 18.3% with CD34 staining were positive,respectively（P 0.05）.Conclusion Microvessel count and microvascular invasion in RCC might be a predictor of tumor aggression,for the patient who had easily got recidivation should have an enhanced follow-up visit,the targeted therapy or other adjuvant therapy should be taken into account early.