食管鳞癌血管内皮细胞生长因子表达与预后的关系

Correlation between Expression of Vascular Endothelial Growth Factor and Prognosis of Patients with Esophageal Squamous Cell Carcinoma

背景与目的:血管形成在肿瘤的生长、侵润、转移中起着重要作用。血管内皮细胞生长因子(vascularendothelialgrowthfactor,VEGF)被认为是最关键的血管形成因子,研究发现在多种肿瘤中VEGF表达水平增高可促进肿瘤的进展并影响其预后,但VEGF与食管鳞癌患者预后之间的关系仍不清楚。本文拟探讨VEGF的表达在判断食管鳞癌患者预后中的价值。方法:采用免疫组化法检测72例食管鳞癌手术切除标本中VEGF蛋白的表达情况,并对其与术后复发转移以及预后间的关系进行回顾性分析。结果:全组病例VEGF表达的阳性率为62.5%(45/72);VEGF阳性组的术后复发转移率高于VEGF阴性组(P<0.001);VEGF阳性组患者的中位生存时间以及1、3、5年生存率均低于VEGF阴性组,VEGF阳性组的Kaplan-Meier生存曲线较阴性组恶劣(Logranktest,P=0.021);多因素分析表明VEGF不是影响预后的独立因素(P>0.05)。结论:VEGF表达水平增高可提示食管鳞癌发生转移的机会增加以及预后恶劣,但对判断患者预后中的价值有待于进一步研究。

Background &Objectives:Angiogenesis plays an essential role in tumor growth,invasion,and metastasis.Vascular endothelial g rowth factor(VEGF)is regarded the most important angio genetic growth factor and it has been found in many kinds of tumors that its high expression can promote tum or progression and effect prognosis.However,there was few reports about the relationship between the VEGF expression and the progression and prognosis of the patients with esophageal carcinoma.The curr ent study was designed to investigate the relationship between VEGF expr ession and the prognosis of patients with esophageal squamous cell carcinoma.Methods:The expression of VEGF protein in 72r esected specimens from the patients with eso phageal squamous cell carcinoma were examined immunohistochemically,and its effects on postoperative recurrence and sur vival of the patients were analyzed r etrospectively.Results:Fourty-five out of 72(62.5%)samples were positive for VEGF expre ssion.The VEGF-positive patients t end to occur postoperative recurren ce than VEGF-negative patients(P<0.001).The median survival time and 1,3,5-year survival rate of VEGF-positive patients was lower than those of VEGF-negative patients.And the Kaplan-Meier survival curve was worse in VEG F-positive groups than in VEGF-negtive groups(Log rank test,P=0.021).Multivariate analysis revealed th at VEGF was not an independent factor that impact on th e prognosis(P>0.05).Conclusions:The high expression of VEGF in esophageal squamous cell carcinoma may promote the tumor progression and lead to dismal prognosis.However,t he value of VEGF expression for judging prognosis need further s tudy.