VEGF、MVD和LN与大肠癌微转移的关系

Relationship of VEGF,MVD and LN with Micrometastasis in Colorectal Carcinoma

目的探讨血管内皮生长因子(VEGF)、微血管密度(MVD)和层黏连蛋白(Laminin,LN)在大肠正常黏膜组织、大肠腺瘤组织及大肠癌组织中的表达及临床意义。方法应用免疫组织化学SP法检测18例正常大肠黏膜组织、26例大肠腺瘤组织和68例大肠癌组织中VEGF和LN的表达水平及MVD计数,并分析他们与大肠癌微转移的关系。结果从大肠正常黏膜逐步发展为大肠癌的过程中,VEGF的表达水平、MVD计数及基底膜明显缺损率均逐渐增加,LN表达减少,大肠癌组织中VEGF的阳性表达率和MVD计数与大肠癌的浸润深度、淋巴结转移、Dukes分期有关(P<0.05)。大肠癌组织中基底膜缺损程度与淋巴结转移、Dukes分期有关(P<0.05)。结论肿瘤的血管形成和LN的表达与大肠癌的淋巴结转移、Dukes分期等临床病理特征密切相关,联合检测VEGF、MVD和LN的表达对判断大肠癌的浸润和转移倾向,进而估计患者的恶性程度。

Objective To investigate the expression and their clinical significance of VEGF,MVD and LN in normal colorectal mucosa,colorectal adenomas and colorectal carcinoma.Methods Expression of VEGF and LN in colorectal cancer,colorectal adenomas and colorectal normal tissues were detected by immunohistochemical staining,and the relationships were analyzed with the expression of VEGF,MVD and LN and micrometastasis in colorectal carcinoma.Results In the process that normal colorectal gradually developing into colorectal cancer,expression of VEGF,MVD and basement membrane obvious defect rate gradually increased（LN expression gradually weakened）,the positive expression rate and MVD was related with depth of invasion of colorectal cancer,lymph node metastasis,Dukes staging（P〈0.05）,but not with the degree of differentiation,patients′ gender,age,tumor location,histological type independent（P〉0.05）.Basement membrane in colorectal carcinoma showed different degrees of defect,or absent,and the degree related with lymph node metastasis,Dukes staging（P〈0.05）,but not with depth of invasion,patients′ gender,age,tumor location and histological type（P〉0.05）.Conclusion There are closely relationship between tumor angiogenesis,expression of LN and metastasis of colorectal cancer,Dukes stage.The combined detection of VEGF,MVD and LN can determine the invasion and tendency metastasis of colorectal cancer,then estimate the degree of malignant,and give a guide of therapy.