血管内皮生长因子与脑膜瘤瘤周水肿的关系

Correlation between vascular endothelial growth factor and peritumoural edema in meningiomas

目的 探讨脑膜瘤血管内皮生长因子 (VEGF)表达与肿瘤血管生成和瘤周脑水肿的关系。方法 采用免疫组织化学技术检测 40例脑膜瘤VEGF表达和微血管密度 ,用双盲法对染色结果及术前MRI和脑血管造影资料进行评估。结果 VEGF表达强阳性组与表达阴性组相比 ,水肿指数(EI =4 6与EI=1 5 ,P =0 0 0 3) ,脑水肿发生率 (88 2 %与 41 7% ,P =0 0 2 3 68)、微血管密度 (MVD =53 0与MVD =2 6 5 ,P =0 0 1 8)的差异均有显著意义 ;有软膜供血组与无软膜供血组相比水肿指数差异有显著意义 (EI=4 4与EI=1 8,P =0 0 4 4 ) ;肿瘤与脑组织重度粘连组较轻度粘连的脑水肿发生率差异有显著意义 (88 9%与 45 5 % ,P =0 0 0 4 1 7) ;肿瘤大小与水肿指数无相关关系 (r =0 2 64 ,P >0 0 5)。结论 脑膜瘤的VEGF表达、肿瘤血管生成及瘤周脑水肿形成之间有重要关系 ;VEGF能促进脑膜瘤的肿瘤血管生成及瘤周脑水肿的形成 ;肿瘤有软膜供血的、与脑组织粘连严重的脑水肿发生率高 ;

Objective To study the relationship between the expression of vascular endothelial growth factor (VEGF) and peritumoural brain edema (PTBE) in meningiomas. Methods The expression of VEGF was investigated in 40 specimens of intracranial supratentorial meningioma resected during operation, using immunohistochemical techniques. The expression of factor VIII related antigen (Ⅷ R Ag) was examined by immunohistochemistry so as to calculate the microvascular density (MVD). The formulae V=4/3π×abc and EI= V edema +V tumor / V tumor were used to determine the edema index (EI). The results of staining were compared with the data by MRI and neuroradiology in double blind fashion. Results Compared to VEGF negative meningiomas, tumours with striking VEGF staining revealed a significantly higher mean EI (4 6 vs 1 5, P =0 003), higher edema incidence (88 2% vs 41 7%, P =0 023 68), and higher MVD (53 0 vs 26 5, P =0 018). Equally, meningiomas with pial supply revealed a significantly higher mean EI than meningiomas with only dural supply (4 4 vs 1 8, P =0 044). Meningiomas severely adhered to brain revealed a higher edema incidence than those with milder adhesion (88 9% vs 45 5%, P =0 004 17). The tumour volume did not correlate with EI ( P >0 05). Conclusion The VEGF expression and tumour angiogenesis are correlated with peritumoural brain edema. The rate of brain edema is higher in the tumors with pial supply and severe adhesion with brain. There is no a significant correlation between the tumour volume and edema degree.