肾上腺皮质癌中COX-2、VEGF的表达及与微血管密度的关系

Expressions of COX-2 and VEGF in adrenocortical carcinoma and their relationship with microvessel density

目的:探讨肾上腺皮质癌组织中环氧化酶-2蛋白(COX-2)、血管内皮生长因子(VEGF)的表达、微血管密度值(MVD)三者的相关性及其在肾上腺皮质癌发生和浸润中的生物学意义。方法:选取经手术治疗,具有完整临床、病理和随访资料的肾上腺皮质肿瘤患者存档石蜡标本20例,其中肾上腺皮质腺瘤组11例,肾上腺皮质癌组9例。另取10例正常肾上腺组织作为对照组。采用免疫组织化学技术,检测良、恶性肾上腺皮质肿瘤及正常肾上腺髓质组织中COX-2、VEGF及MVD表达情况。结果:COX-2在恶性组中表达最高,良性组中表达较低,对照组中无表达,恶性组与良性组及恶性组与对照组之间COX-2的表达差异有统计学意义(P<0.05)。VEGF在恶性组中呈高表达,VEGF在恶性组中的表达与在良性组和对照组中的表达差异有统计学意义(P<0.05),在良性组和对照组中的表达差异没有统计学意义(P>0.05)。MVD在恶性组中表达最高,良性组次之,对照组最少,两两之间的表达差异有统计学意义(P<0.05)。在肾上腺皮质肿瘤中COX-2与VEGF的表达呈正相关,COX-2的表达与MVD呈正相关,VEGF的表达与MVD呈正相关。结论:COX-2、VEGF和MVD可作为肾上腺皮质癌发生、发展及浸润的参考指标。

Objective：To study the expressions of cyclooxygenase-2（COX-2）,vascular cell growth factor（VEGF） and MVD and their correlation in adrenocortical carcinoma and to explore their biological significance in occurrence and infiltration of adrenocortical carcinoma.Methods：Tissue specimens were obtained at operations.There were 20 adrenocortical tumors（including 11 adrenocortical adenoma and 9 adrenocortical carcinoma） and the clinical and pathological data were available.Normal adrenal glands were from 10 patients undergoing nephrectomy for a benign renal tumor.Immunohistochemical technology was performed to detect the COX-2,VEGF and MVD.Results：Strong COX-2 expression was found in adrenocortical carcinoma.Whereas weak COX-2 expression in adrenocortical adenoma and no expression in normal adrenal cortex.There was statistical difference between malignant group and benign group,also between malignant group and normal adrenal cortex group（P0.05）.Strong VEGF expression was found in adrenocortical carcinoma,whereas weak expression in adrenocortical adenoma and in normal adrenal cortex respectively.There was statistical difference between malignant group and benign group,also between malignant group and normal adrenal cortex group（P0.05）.However there was no statistical difference between benign group and normal adrenal cortex group（P0.05）.High MVD expression was found in adrenocortical carcinoma,whereas low expression in adrenocortical adenoma and in normal adrenal cortex.There was statistical difference between groups（P0.05）.There was positive relationship between COX-2 and VEGF in adrenocortical tumors,also between COX-2 and MVD.Meanwhile we also found the positive relationship between VEGF and MVD.Conclusion：COX-2,VEGF and MVD may be as the reference index of the development and infiltration in adrenocortical carcinoma.