血管生成拟态在胆囊癌表达的形态学研究及其临床意义

A Preliminary Study of Vasculogenic Mimicry in Human Primary Gallbladder Carcinoma and Its Clinical Significance

目的观察原发性胆囊癌组织中血管生成拟态(VM)的形态学改变,初步探讨其存在的临床意义。方法联合应用免疫组织化学双染法标记原发性胆囊癌VM的形态,结合病例资料,分析VM病理形态学改变与临床特征的关系。结果原发性胆囊癌组织中VM阳性表达率为15.38%(8/52),低分化组的VM阳性率显著高于高分化组(P<0.05),VM表达与胆囊癌肝转移显著相关(P<0.05),VM阳性组和阴性组中位生存期分别为11月和15月,Kaplan Meier生存分析提示两者差别有统计学意义(P<0.01)。结论原发性胆囊癌组织中存在VM,与胆囊癌低分化及血道转移相关,VM可作为初步判断胆囊癌预后的病理学指标。

Objective To observe the morphology of vasculogenic mimicry（VM） in human prima- ry gallbladder carcinoma, and to discuss its clinical significance. Methods To detect the VM in primary gallbladder carcinoma by immunohistochemical double staining of CD31 and PAS, and to analyze the corre- lation between pathological morphology and clinical features in clinical cases. Result The positive rate of VM in primary gallbladder is 15.38%（8/52） and is significantly higher in poorly differentiated group thanthat in highly differentiated group（P〈0.05）, it also correlates with hepatic metastasis closely. The me- dium patient survival time in VM positive group is 11 months while 15 months in negative one. Kaplan Meier analysis（P〈0.01） shows that the above difference reaches statistical significance. Conclusion VM positive in human primary gallbladder carcinoma is correlated to both poorly differentiated and hemat- ogeneous metastasis. VM may be a pathological marker for preliminary determination for prognosis of gallbladder carcinoma.