NSCLC的微血管密度及结构与预后的关系

The relationship between microvessel density and structure in cancer tissues and prognosis in patients with non-small cell lung cancer

目的 探讨非小细胞肺癌 (NSCLC)组织内微血管密度 (MVD)和微血管结构 (MVS)特征与患者预后的关系。方法 采用免疫组化LsAB法 ,以Von Willebrand因子抗体显示血管内皮细胞 ,镜下观察 49例NSCLC患者肿瘤组织中微血管的数量与结构特征。根据其形态的不同 ,把微血管分为A、B两型 ,A型主要表现为血管壁较厚或较完整 ,管形较规则 ,常分散存在 ;B型主要表现为血管壁薄或不完整 ,管形不规则 ,常丛状或网状分布。结果 ①原发NSCLC组织内MVD与患者pTNM分期和淋巴结受累与否密切相关 ,P值分别为0 .0 43和 0 .0 3 8,而MVS与原发瘤大小密切相关 ,P =0 .0 0 2 ;②原发NSCLC组织内MVD较高者 (>5 2 /2 0 0×视野)的生存期 (2 3 .2月± 18.4月 )明显短于MVD较低者 (<5 2 /2 0 0×视野) (3 5 .9月± 2 0 .9月 ) ,P =0 .0 1;③原发NSCLC组织内MVSA型者的生存期 (3 9.4月± 17.2月 )明显长于MVSB型者 (2 3 .5月± 2 0 .3月 ) ,P =0 .0 0 8;④原发NSCLC组织内MVD <5 2 /2 0 0×视野 且MVSA型者的生存期 (4 2 .9月± 19.3月 )明显长于MVD >5 2 /2 0 0×视野 且MVSB型者 (15 .7月± 16.8月 ) ,P =0 .0 0 2。结论 原发NSCLC组织内MVD和MVS特征与患者预后密切相关 。

Objective To explore the correlation of microvessel density (MVD) and microvessel structure (MVS) features with the patients' prognosis in non small cell lung cancer (NSCLC). Methods Anti Von Willebrand factor antibody was used to stain microvessel endothelia by means of LsAB immunohistochemical technique, then the microvessel count and structure features were observed microscopically in 49 primary NSCLC tissues. MVS pattern A had scattered microvessels with relatively integral or thick wall and with relatively regular morphology and MVS pattern B had plexiform or network like microvessels with unintegral or thin wall and with irregular morphology. Results MVD in primary NSCLC tissues was closely correlated with pTNM stage or lymph node involvement, P=0.043 and P=0.038, respectively. MVS in primary NSCLC tissues was closely correlated with the size of primary carcinoma, P=0.002. The survival of patients (23.2± 18.4 months) with MVD>52/ 200× was significantly shorter than that of patients (35.9±20.9 months) with MVD<52/ 200× in primary NSCLC tisssues, P=0.01. The survival of patients with MVS pattern A (39.4±17.2 months) was significantly longer than that of patients with MVS pattern B (23.5±20.3 months) in primary NSCLC tisssues, P=0.008. The survival of patients with MVD<52/ 200× and MVS pattern A (42.9±19.3 months) was significantly longer than that of patients with MVD>52/ 200× and MVS pattern B (15.7±16.8 months) in primary NSCLC tissues, P=0.002. Conclusion MVD and MVS are closely associated with prognosis of NSCLC patients and might be served as parameters estimating patients' prognosis and planning assistant therapy after operation.