胃癌淋巴管密度、微血管密度水平及其临床意义

Lymphatic vessel density and microvessel density in gastric cancer and their clinical significance

目的探讨胃癌组织中淋巴管密度(LVD)和微血管密度(MVD)水平及两者与胃癌临床病理特征的关系。方法收集本院2004年2月至2007年2月手术切除的68例胃癌患者肿瘤组织,分别采用D2-40和CD31标记胃癌组织中淋巴管和血管,采用免疫组化法检测瘤周及瘤内D2-40、CD31表达情况并计算LVD和MVD,分析瘤周及瘤内LVD、MVD水平与临床病理参数(肿瘤大小、淋巴结转移、脏器转移、TNM分期、性别、年龄、分化程度、Lauren分型及病理类型)和预后的关系。结果 68例患者瘤内和瘤周LVD分别为(4.6±2.0)个和(8.2±3.5)个,瘤内和瘤周MVD分别为(46.3±16.5)个和(47.6±15.3)个;瘤周LVD与肿瘤大小、淋巴结转移、脏器转移及TNM分期有关(P<0.05),与性别、年龄、分化程度、Lauren分型及病理类型均无关(P>0.05);瘤内LVD、瘤内及瘤周MVD与以上参数均无关(P>0.05);全组中位总生存期(OS)为48.6个月,其中瘤周低LVD者的中位OS为31.0个月,低于瘤周高LVD的43.0个月(P<0.05);瘤周高MVD者的中位OS为46.0个月,而瘤周低MVD者为48.0个月,差异无统计学意义(P>0.05)。结论瘤周LVD与胃癌的临床病理特征及预后密切相关,可能成为胃癌发展及预后的预测指标。

Objective To investigate the levels of lymphatic vessel density（ LVD） and microvessel density（ MVD） in gastric cancer tissue and their relationship with clinicopathological features. Methods The gastric cancer tissues from 68 patients with gastric cancer were collected from February 2004 to February 2007. The LVD and MVD were marked by D2-40 and CD31,respectively. The immunohistochemistry was used to detect the peritumoral and intratumoral expressions of D2-40 and CD31 to calculate LVD and MVD. Then relationships between peritumoral and intratumoral LVD,MVD and clinicopathological variables（ tumor size,lymph node metastasis,visceral metastasis,TNM stage,sex,age,degree of differentiation,Lauren type and pathological type） and prognosis were analyzed. Results The peritumoral and intratumoral LVD were 4. 6 ± 2. 0 and 8. 2 ± 3. 5,and the peritumoral and intratumoral MVD were 46. 3 ±16. 5 and 47. 6 ± 15. 3,respectively. The peritumoral LVD is related with tumor size,lymph node metastasis,visceral metastasis and TNM stage,but not with sex,age,degree of differentiation and pathological type（ P〉0. 05）. There was no relationship between the above clinicopathological features and intratumoral LVD,peritumoral and intratumoral MVD. The median overall survival（ OS） was 48. 6months. The median OS of patients with peritumoral low LVD was 31. 0 months,shorter than 43. 0 months of peritumoral high LVD with significant differences（ P〈0. 05）. The median OS of patients with peritumoral high and low MVD was 46. 0 and 48. 0 months with no significant difference（ P〉0. 05）. Conclusion The peritumoral LVD is closely related with the clinicopathological factors and prognosis of gastric cancer,which may play a predictive role in the development and progression of gastric cancer.