血管内皮生长因子-C在胃癌中的表达及与淋巴结转移的关系

Correlation between expression of vascular endothelial growth factor C and lymph node metastasis in gastric carcinoma

目的研究血管内皮生长因子-C(VEGF-C)在胃癌组织中的表达并探讨其与肿瘤淋巴结转移的关系。方法取87例胃癌患者手术切除的新鲜标本和距癌灶5cm以外的胃组织各一块,应用逆转录-聚合酶链反应(RT-PCR)法和免疫组化染色法检测胃癌组织及癌旁组织的VEGF-C表达。结果 VEGF-C在胃癌细胞中呈高水平表达,癌旁正常组织未见表达。VEGF-CmRNA、VEGF-C蛋白在胃癌组织中的阳性率分别为55.1%、65.5%。在伴淋巴结转移的胃癌中,VEGF-C表达较无淋巴结转移者更显著(P<0.01)。同时,VEGF-C表达与淋巴管浸润和TNM分期密切相关(P<0.01),但与肿瘤大小、Lauren分型、浸润深度和血管浸润均无明显相关。在目前的回顾性研究中,VEGF-C表达预测胃癌淋巴结转移的敏感性、特异性、准确率分别为77.19%6、0.61%7、3.56%。结论 VEGF-C的表达与胃癌淋巴结转移密切相关。在内镜活检标本上检测VEGF-C表达,对于预测有关淋巴结转移和判定淋巴结清除范围可能有价值。

Objective： To study the expression of vascular endothelial growth factor C（VEGF-C） in gastric carcinoma and its relationship with lymph node metastasis.Methods：The expression of VEGF-C mRNA in gastric carcinoma was examined by reverse transcription polymerase chain reaction（RT-PCR）.Simultaneously,the expression of VEGF-C protein in gastric carcinoma tissues obtained from 87 patients who underwent radical gastrectomy was detected by immunohistochemistry.Results：Expressed VEGF-C mRNA,VEGF-C protein was expressed in 55.1%（48/87）and 65.5 %（57/ 87） of patients.VEGF-C protein expression was more frequently detected in tumors with lymph node metastasis than in those without（P0.01）.VEGF-C protein expression was also closely related to lymphatic invasion（P0.01） and TNM stage（P0.01）.However,there was no significant correlation between VEGF-C expression and tumor size,Lauren classification,depth of invasion and vascular invasion.In the current retrospective study,the sensitivity,specificity and accuracy of VEGF-C expression in the diagnosis of lymph node metastasis for patients with gastric carcinoma were 77.2%,60.6% and 73.6% respectively.Conclusion： The expression of VEGF-C is closely related to lymph node metastasis of gastric carcinoma.The examination of VEGF-C expression in endoscopic biopsy specimens may be useful in predicting lymph node metastasis of gastric carcinoma and deciding the extent of surgical lymph node resection.