非小细胞肺癌组织Bmi-1和VEGF表达及其临床意义的研究

Expression and clinical significance of Bmi-1 and vascular endothelial growth factors in non-small cell lung cancer

目的:探讨鼠类淋巴瘤滤过性病毒致癌基因(Bmi-1)和血管内皮生长因子(VEGF)在非小细胞癌(NSCLC)组织中的表达及其与临床预后的相关性。方法:应用免疫组化SABC法检测180例NSCLC组织中Bmi-1与VEGF表达水平及微血管密度(MVD)。结果:NSCLC组织中Bmi-1阴性表达为10.6%(19/180),阳性表达率为30.6%(55/180),强阳性表达率为58.9%(106/180);Bmi-1与癌旁组织比较,差异有统计学意义,P=0.026。Bmi-1的表达与VEGF表达密切相关,P=0.001;并且Bmi-1高表达也同时伴随着MVD计数增高,P=0.005。在VEGF强阳性/Bmi-1阳性组的23例患者中有14例(60.9%)MVD计数增高,差异有统计学意义,P=0.001。在VEGF强阳性/Bmi-1强阳性组的41例患者中有34例(82.9%)MVD计数增高,差异有统计学意义,P=0.001。多因素统计分析显示,Bmi-1阳性或强阳性合并VEGF强阳性表达、淋巴结转移和MVD增高是NSCLC预后的独立危险因素。结论:Bmi-1在NSCLC的肿瘤血管生成和进展中起重要作用,Bmi-1和VEGF同时高表达是NSCLC不良预后的因素。

OBJECTIVE：To investigate the expression of Bmi-l,vascular endothelial growth factor（VEGF） and their relationships with cliniepathologic characteristics and their effects on the prognosis in non-small cell lung cancer （NSCLC）. METHODS：The expressions of Bmi-1 ,VEGF and microvessel density （MVD） in 180 cases of NSCLC tissues were evaluated by immunohistochemistry. RESULTS： Bmi-1 expression was negative in 19 cases （10. 6% ）, positive in 55 cases （30.6 % ） and strongly positive in 106 （58.9 %） of 180 cases. A significant correlation was found between Bmi-1 and VEGF expressions （P=0. 001） and between Bmi-1 expression and MVD （P=0. 005） ,while a high MVD was found in 14 （60.9%） of 23 tumors with a strongly positive VEGF and positive Bmi-1 expression and in 34（82.9%） of 41 tumors with a strongly positive VEGF and strongly positive Bmi-1 expression. Although there was no difference in the disease free survival （DFS） stratified according to Bmi-1 expression alone,the 48 patients with a strongly positive VEGF and a strongly positive or positive Bmi-1 expression had a significantly worse DFS than those with other combinations of VEGF and Bmi- 1 expressions. Multivariate analysis indicated the high expression of both Bmi-1 and VEGF, lymphnode metastasis and MVD to be independently significant prognostic factors for DFS. CONCLUSIONS： The Bmi-1 expression is found to be closely correlated with VEGF expression and MVD in NSCLC,while high MVD is frequently found in tumors with a high expression of both Bmi-1 and VEGF. The survival analysis demonstrates a high MVD,which is induced by a high expres sion of both Bmi-1 and VEGF,have a strong prognostic significance in NSCLC.