VEGF、MMP2、MVD与卵巢癌临床病理关系的研究

Expressions of VEGF,MMP2 and microvessel density in ovarian carcinoma.

目的 :研究卵巢癌中VEGF、MMP2的表达和MVD与临床病理参数和预后的关系并探讨其临床价值。方法 :采用免疫组化技术检测 5 3例卵巢癌和 10例卵巢交界性肿瘤中VEGF、MMP2的表达水平 ,用CD34标记新生血管内皮细胞 ,在显微镜下观察血管密度。结果 :卵巢癌中MVD与年龄呈正相关 (P =0 .0 16 ) ,粘液性囊腺癌中MVD高于其它组织学类型 (P <0 .0 1)。卵巢癌中VEGF的表达与FIGO手术分期呈正相关 (P =0 .0 0 1) ,VEGF表达还与腹水量呈正相关 (P =0 .0 0 2 )。MVD与VEGF、MMP2表达呈正相关 (P值分别为 0 .0 2 1和 0 .0 31) ,VEGF表达与MMP2表达呈正相关 (P =0 .0 0 2 )。VEGF、MMP2强阳性表达和MVD较高 (≥ 10 /HP)的患者预后差 (P值分别为 0 .0 2 6 ,0 .0 36和 0 .0 38)。结论 :VEGF是重要的血管生成因子 ,MMP2不仅在肿瘤的浸润和转移中意义重大 ,而且在肿瘤的血管生成中发挥作用。卵巢癌的FIGO手术分期、MVD及VEGF、MMP2表达与预后相关 ,特别是MMP2在肿瘤的浸润、转移和血管生成中有双重作用 ,既有助于判断患者对传统治疗的敏感性 ,而且对开发针对肿瘤的生物特异性治疗具有启发作用。

Objective:To study on the relationships of the expressions of vascular endothelial growth factor (VEGF),72kDa metalloproteinase (MMP2),and microvessel density (MVD) linked with several clinicopathologic and demonstrat prognostic parameters.Methods: The representative paraffin sections was selected and 61 specimens of ovarian cancer were tested by immunohistochemical techique with polyclonal antibody against VEGF and MMP2.CD34 was used to detect vascular endothelial.MVD was determined by microscopy. Results: MVD was significantly correlated with age (P=0.016),the expressions of VEGF (P=0.021) and MMP2(P=0.031).Compared with other histological type,there was a significantly higher MVD in mucinous tumours (P<0.01).The expression of VEGF was significantly correlated with tumours' FIGO stage (P=0.001 and P= 0.003,respectively);a significant correlation between the expressions of VEGF and ascites fluid volume was observed (P=0.002).The expression of VEGF was significantly correlated with that of MMP2 (P=0.002).The patients with strong expressions of VEGF,MMP2 and higher MVD (≥10/HP) had unfavourable prognosis (Log-rank P=0.026,P=0.036 and P=0.038,respectively). Conclusions: VEGF plays an important role in the angiogenic process in ovarian carcinoma;MMP2 is a critical factor not only in tumours' invasion and metastasis,but also in the process of tumor angiogenesis.FIGO stage,MVD,the expressions of VEGF and MMP2 are useful predictor of survival in patients with epithelial ovarian cancer.The dual function of MMP2 in both angiogenesis and tumours' invasion and metastasis arouse a new strategy of biological special treatment of tumor.