淋巴管新生与肾透明细胞癌预后的相关性分析

Analysis of relationship between lymphangiogenesis and the prognosis of renal clear cell carcinoma

目的分析淋巴管新生与肾透明细胞癌患者预后的关系。方法用二步法免疫组织计数检测60例肾透明细胞癌患者标本中D2-40表达阳性的淋巴管,用光学显微镜测定癌周淋巴管密度,并观察是否出现癌内淋巴管,评价癌周淋巴管密度及癌内淋巴管与临床预后因素及患者生存率的关系。结果癌周淋巴管平均密度为16.89,按大于或小于平均值分为2组进行相关性分析表明,癌周淋巴管密度与远处转移、淋巴结转移、Fuhrman细胞核分级和肿瘤T分期无显著相关性(P>0.05)。癌内淋巴管的出现与远处转移、淋巴结转移及Fuhrman细胞核分级有显著相关性(P<0.05),与肿瘤T分期无相关性。生存分析显示,癌周淋巴管密度≥16.89组总体生存率为50.76%,癌周淋巴管密度<16.89组总体生存率为63.07%(P>0.05)。癌内淋巴管阳性组的总体生存率为30.86%,癌内淋巴管阴性组的总体生存率为64.36%(P<0.05)。结论癌周淋巴管密度对肾透明细胞癌患者的预后无影响,癌内淋巴管是肾透明细胞癌患者预后的不良因素。

Objective To discuss the correlation between lymphangiogenesis and prognostic in patients with renal clear cell carcinoma.Methods The D2- 40 antibody was used to mark lymphatic vessels of samples contained 60 patients with renal clear cell carcinoma through the method of immunohistochemical stain. Light microscopy was used to determine the peritumoral lymph vessels density（ PLVD） and observe the presence of intratumoral lymphatic vessels（ ILVs）. Correlation between the numbers and clinical prognosis factors and survival rates of patients was assessed. Results Mean PLVD was 16. 89,and no significant difference was found between the patients with PLVD below average and those with PLVD above average in terms of distant metastasis（ P〉0. 05）,lymph node metastasis（ P〉0. 05）,the Fuhrman nuclear grade（ P〉0. 05）,tumour stage（ P〉0. 05）. A significant correlation was found between the presence of ILVs and distant metastasis（ P〈0. 05）,lymph node metastasis（ P〈0. 05） and the Fuhrman nuclear grade（ P〈0. 05）. However,no significant correlation was found between the tumour T stage（ P〉0. 05）. Survival analysis showed that overall survival rate of group with PLVD above average is 50. 76%,and the group with PLVD below average was 63. 07%,the survival rateof two groups was no of significant difference（ P〉0. 05）. The overall survival rate of ILV- positive group was30. 86%,the ILV- negative group was 64. 36%,extremely significant differences was found between the two groups（ P〈0. 05）. Conclusion PLVD may be no effect on the prognosis of patients with renal clear cell carcinoma. The emergence of ILVs may be a bad prognosis factor for renal clear cell carcinoma.