胃癌中D2-40和CD34的表达及临床意义

Expression and clinical significance of D2-40 and CD34 in gastric cancer

目的探讨D2-40和CD34在胃癌组织中的表达及D2-40阳性的淋巴管密度(LVD)和CD34阳性的微血管密度(MVD)与临床病理特征和预后的关系。方法采用组织芯片和免疫组化技术检测108例胃癌和36例癌旁组织中D2-40和CD34的表达情况,并分别计数D2-40阳性的LVD和CD34阳性的MVD,分析两者与临床病理特征和预后的关系。结果D2-40在胃癌和癌旁组织中的阳性表达率分别为85.2%(92/108)和22.2%(8/36),差异有统计学意义(P=0.000);CD34在胃癌组织中的阳性表达率为94.4%(102/108),高于癌旁组织的36.1%(13/36),差异有统计学意义(P=0.000)。胃癌组织中LVD和MVD计数分别为10.14±5.37和45.32±15.78,显著高于癌旁组织中的3.38±1.69和4.92±1.26,差异均有统计学意义(P均为0.000);单因素分析显示两者与肿瘤大小、浸润深度、淋巴结转移、TNM分期有关,与性别、年龄无关。Cox多因素分析显示肿瘤大小、浸润深度、淋巴结转移、TNM分期及MVD和LVD是胃癌预后的独立影响因素。Kaplan-Meier生存分析显示,乏淋巴管组的中位生存时间为69.0个月(95%CI:59.91～77.20个月),高于富淋巴管组的33.0个月(95%CI:23.20～42.66个月);乏微血管组的中位生存时间为67.0个月(95%CI:58.10～76.39个月),高于富微血管组34.0个月(95%CI:24.63～44.02个月),上述差异均有统计学意义(P<0.05)。结论 D2-40标记的LVD和CD34标记的MVD与胃癌的临床病理特征密切相关,有望成为胃癌发展及预后的预测指标。

Objective To investigate the expression of D2-40 and CD34 with lymphatic vessel density（LVD） marked by D2- 40 and microvessel density（MVD） marked by CD34 in gastric cancer and the correlation of them with clinical pathological features.Methods Expressions of D2-40 and CD34 were detected in 108 cases of gastric cancer and 36 cases of adjacent normal tissues using immunohistochemistry and tissue microarray. The LVD marked by positive D240 and MVD by positive CD34 were calculated, and the correlation with the clinical pathological features and prognosis were analyzed. Results The positive rate of D2-40 in gastric cancer was 85.2% （ 92/108 ）, higher than 22. 2% （ 8/36 ） in adjacent normal tissue with significance（ P = 0. 000 ） ; the positive rate of CD34 was 94. 4% （ 102/108 ） in gastric cancer, higher than 36. 1% （ 13/36 ） in adjacent normal tissue with significance （ P = 0. 000 ）. The LVD（ 10. 14±5.37）and MVD（45.32 ± 15.78）in gastric cancer were significantly higher than 3.38±1.69 and 4. 92±1.26 in adjacent normal tissues（ P = 0. 000, P = 0. 000）. The expression of D2-40-LVD and CD34-MVD in the malignancy were related to the tumor size, invasion depth, lymphatic metastasis and TNM stage, but not with age and sex. Cox muhivariant analysis showed that the tumor size, invasion depth, lymphatic metastasis, TNM stage, MVD and LVD were independent factors affecting prognosis. The Kaplan-Meier analysis showed that the median overall survival of the few-lymphatic vessel group was 69.0 months （95% CI： 59. 91-77.20months） and that of the muhi-lymphatic vessel group was 33.0 months （95 % CI：23. 2042. 66months） with significance; the median overall survival of few-blood microvessel group was 67. 0 months （95% CI ： 58.10-76. 39 months） and that of multi-blood microvessel group was 34. 0 months （95 % CI： 24. 63-44. 02 months） with significance （P 〈 0. 05 ）. Conclusion The LVD marked by D2-40 and MVD marked by CD34 are positively correlated to the clinicopathological factors of the malignancy, and may play an predictive role in the development and progression of gastric cancer.