胃癌血管内皮生长因子的表达与微血管密度的关系及其临床意义

Clinical significances and relationship between vascular endothelial growth factor expression and microvessel density in gastric carcinoma

目的 探讨胃癌组织中血管内皮生长因子 (VEGF)的表达和微血管密度 (MVD)的关系 ,以及这两项指标与临床病理特征和预后之间的关系。方法 观察分析 116例胃癌组织中VEGF的表达和计算微血管密度 (MVD ) ,分析VEGF的表达与MVD间的关系及它们与临床病理因素和预后的关系。结果 116例胃癌组织中 ,VEGF的阳性率为 6 0 .34 %。VEGF阳性组中的MVD值明显高于VEGF阴性组 (分别为 2 6 .16± 8.5 0和 19.2 2± 8.2 0 ,P <0 .0 1)。在淋巴结转移组中VEGF表达的阳性率明显高于无淋巴结转移组 (P <0 .0 5 )。在肿瘤分期晚的病人中 ,其VEGF表达的阳性率也明显高于分期早的 (P <0 .0 5 )。MVD与胃癌的淋巴结转移及腹腔内转移有关 (P均 <0 .0 1) ,且随TNM分期而增加 (P <0 .0 1)。VEGF表达阴性组和低MVD组 (MVD <2 3)的 5年生存率均明显高于VEGF表达阳性组和高MVD组 (MVD≥ 2 3)(均P <0 .0 1)。多因素分析表明 ,MVD和VEGF的表达均是独立的预后因素。结论 胃癌组织中VEGF的表达和MVD能反映胃癌的恶性程度 。

Objective To evaluate the correlation between vascular endothelial growth factor(VEGF) expression and microvessel density(MVD) in gastric carcinoma (GC) and the relationship of VEGF and MVD with clinicopathologic characteristics and prognosis of GC. Methods The expression of VEGF and intratumoral microvessel density (MVD) in one hundred and sixteen resected specimens of the patients with GC were observed and counted, and the relationship of VEGF and MVD with clinicopathologic factors and prognosis of GC were analysed. Results The expression of VEGF was found in 60.34% of the specimens. The MVD value was much higher in VEGF(+) group than that in VEGF(-) group (26.16±8.50 and 19.22±8.20, respectively, P<0.01). Expression of VEGF was significantly higher in patients with lymph node metastasis than that in patients without lymph node metastasis (p<0.05).Expression of VEGF was highly correlated with the stage of tumor (P<0.05). MVD correlated with lymph node metastasis (P<0.01) and abdomen metastasis (P<0.01) and increased with the TNM stage (P<0.01). The total five year survival rate in VEGF( ) group and low MVD group were significantly higher than that in VEGF(+) group and high MVD group respectively(both P<0.01). Multivariate analysis indicated that the expression of VEGF and MVD were independent prognostic factors of GC. Conclusions The expression of VEGF and MVD can reflect the malignant degree of GC. They may serve as the prognostic factors and guide the decisions on the therapy.