VEGF-C联合病理分级预测和诊断膀胱癌淋巴转移的意义

Significance of VEGF-C combined with pathological grading in prediction and diagnosis of bladder cancer lymphatic metastasis

目的探讨膀胱尿路上皮癌血管内皮生长因子C（VEGF-C）联合膀胱癌病理分级预测和诊断淋巴结转移的临床价值。方法采用免疫组化方法研究127例膀胱癌行膀胱全切患者术的肿瘤VEGF-C的蛋白水平的表达,术后常规病理检查淋巴结有无转移。追查根治术前1~2年病理结果及VEGF-C的蛋白水平的表达。结果膀胱癌组织中VEGF-C蛋白表达显著高于正常膀胱组织,且淋巴结转移组癌组织中VEGF-C蛋白表达显著高于淋巴结未转移组。VEGF-C评估膀胱癌淋巴结转移的敏感性、特异性和准确性分别是：87.0%,67.9%,74.8%;高级别膀胱癌中敏感性、特异性、准确性分别为94.9%,75.0%,83.2%;低级别膀胱癌中分别为85.7%,92%,90.6%。结论 VEGF-C与膀胱癌淋巴道浸润和转移有显著相关性,检测膀胱癌VEGF-C表达能够评估盆腔淋巴结是否转移。联合膀胱癌病理分级可提高诊断价值。

[ Objective ] The purpose ofthis stu-dy is to determine whether ;~ascular endothelial growth factor C （VEGF-C） associated with Patho-grade have relationship with lymph node metastasis in Bladder Transitional Cell Carcinoma （BTCC）, and estimate clinical value. [ Methods ] We assessed VEGF-C expression using immunohistochemistry in 127 BTCC. Radical cystectomy and pelvic lymph adenectomy were performed in all patients. All specimen accepted pathologic check and investigated 72 case pathologic check and VEGF-C expression for 1-2 years before radical correction. [ Results ] There was VEGF-C expression in the tumor ceils, but very little in the normal transitional epithelium. In the group of BTCC Positive VEGF-C was significantly correlated with lymph node metastasis （P〈O.05）. The sensitivity, specificity and accuracy of VEGF-C was 87.0%, 67.9%, 74.8%, respectively. The sensitivity, specificity and accuracy in high-grade BTCC was 94.9% ,75.0% ,83.2%, respectively,.in low-grade BTCC was 85.7%, 92.0% ,90.6%. [ Conclusion ] Positive VEGF -C was significantly correlated with lymph node metastasis of the BTCC. VEGF-C expression in biopsy specimens might be beneficial in predicting pelvic lymph node metastasis, It can improve the accuracy and value when combined pathologic grade.