鼻息肉与鼻咽癌标本VEGF水平及微血管密度对比及其临床意义

Comparison of VEGF and Microvascular Density in Nasal Polyps and Nasopharyngeal Carcinoma and its Correlation with Clinical Features of Nasopharyngeal Carcinoma

目的:对比研究鼻咽癌和鼻息肉标本中VEGF表达强度及MVD差异,同时分析VEGF、MVD和鼻咽癌临床特征的相关性。方法:纳入我科就诊的鼻咽癌患者57例,鼻息肉患者50例。采用免疫组化SABC法检测癌组织、癌旁组织、及息肉组织中中VEGF蛋白的表达,及MVD强度。分析VEGF、MVD和鼻咽癌患者性别、临床分期、颈部淋巴结转移、远处转移、血清EBV-Ig A阳性、WHO病理分型相关性。统计分析随访结果,对可能影响鼻咽癌预后的因素进行Cox回归模型分析。结果:鼻咽癌组织、鼻咽癌旁组织、鼻息肉组织中VEGF表达、MVD强度具有明显差异(p<0.05)。不同鼻咽癌临床分期、是否发生远处转移、不同WHO病理分型和VEGF表达、MVD强度具有明显差异(p<0.05)。Cox回归方程显示,远处转移、病理分型、VEGF表达强度是影响鼻咽癌生存的独立危险因素(p<0.05)。结论:鼻咽癌高表达VEGF,促进新生血管,形成高密度微小血管,和鼻咽癌远处转移密切相关,降低其生存率。

Objective： To investigate the VEGF expression and microvessle density （MVD） in nasopharyngeal carcinoma and nasal polyps specimens and compare their differences between the two kinds of specimens, as well as to analyze the correlation of VEGF and MVD with the clinical features of nasopharyngeal carcinoma （NPC）. Methods： In this study included were 57 cases of nasopharyngeal carcinoma patients and 50 patients with nasal polyps. By immunohistochemical SABC method, the expression of VEGF protein and the intensity of MVD were detected in cancerous tissues, the tissues adjacent to carcinoma, and nasal polyps tissues. The correlation of VEGF and MVD were analyzed with the sex, clinical stage, cervical lymph node metastasis, distant metastasis, positive serum EBV-IgA, and WHO pathology classification of NPC patients. And follow up NPC patients to June 2016. The possible factors affecting the prognosis of NPC were analyzed with the Cox regression model. Results： There was significant difference in expression of VEGF and MVD intensity between nasopharyngeal carcinoma tissues, nasopharyngeal carcinoma adjacent tissues and nasal polyps tissues （p〈0.05）. Different NPC clinical stage, distant metastasis or not, and different WHO pathological classification had correlation with the VEGF expression and MVD intensity （p〈0.05）. Cox regression equation showed that distant metastases, the pathologic classification, the intensity of VEGF expression were independent risk factors of the survival of NPC patients （p 〈 0.05）. Conclusion： The high expression of VEGF in nasopharyngeal carcinoma could promote new blood vessels and form high density of tiny blood vessels. It had close relation with the NPC distant metastasis and reduced the survival rate.