甲状腺未分化癌组织vWF表达与血管生成拟态相关性研究

Expression of vWF and its relationship with vasculogenic mimicry in anaplastic thyroid carcinoma tissues

目的肿瘤源性的血管性血友病因子(von Willbrend factor,vWF)表达及血管生成拟态(vasculogenic mimicry,VM)形成都是高度恶性肿瘤中的高频事件。本研究检测甲状腺未分化癌组织中vWF的表达及VM水平,在组织学水平上探讨vWF的表达及其与肿瘤组织中VM形成的相关性。方法选取甘肃省人民医院(20例)及甘肃省肿瘤医院(43例)2000-01-01-2014-12-31病理诊断为甲状腺未分化癌的手术标本63例。同时随机挑选甘肃省人民医院同期甲状腺乳头状癌病例63例和相应癌旁正常组织作为对照。采用免疫组化法检测甲状腺组织中vWF蛋白的表达水平,CD31联合PAS双重染色检测VM水平。结果vWF蛋白在正常甲状腺组织无表达,甲状腺乳头状癌中有5例(7.90%)阳性表达,甲状腺未分化癌中vWF阳性表达31例(49.20%),组间比较差异有统计学意义,χ~2=26.289,P<0.001。vWF在甲状腺未分化癌中的阳性表达与患者的性别、年龄、肿瘤大小和淋巴结转移无关,而与远处转移(χ~2=5.341,P=0.021)和临床分期(χ~2=4.753,P=0.029)相关。VM在正常甲状腺组织、乳头状癌及甲状腺未分化癌中的形成率分别为0、3.20%和34.92%,组间差异有统计学意义,χ~2=20.588,P<0.001。VM形成与肿瘤最大径(χ~2=4.789,P=0.029)、淋巴结转移(χ~2=5.684,P=0.028)、远处转移(χ~2=4.722,P=0.030)和临床分期(χ~2=5.777,P=0.061)相关。vWF的表达与VM水平正相关,r=0.411,P=0.001。结论甲状腺未分化癌中有不同程度vWF的高表达,其高表达与VM的形成正相关,vWF的高表达可能是导致甲状腺未分化癌预后差的因素之一。

OBJECTIVE Both of the expression of tumor-derived von Willebrand factor（vWF）and the formation of vasculogenic mimicry（VM）are highly frequent events in badly malignant tumor.The objective of this study was to investigate the expressional level of vWF and the formation of VM in anaplastic thyroid carcinoma and to explore the relationship between vWF and VM from the tissue level.METHODS Totally 63 cases with diagnosed histologically as anaplastic thyroid carcinoma were collected from Gansu Provincial People＇s Hospital（20cases）and Gansu Provincial Medical Science Institute（43cases）from January 1st 2000 to December 31 st 2014.The proportion of vWF was detected by immunohistochemistry in 63 cases of anaplastic thyroid carcinoma,63 cases of papillary thyroid carcinoma（Gansu Provincial People＇s Hospital）and 63 cases of the normal thyroid tissue（Gansu Provincial People＇s Hospital）.The presence of VM was detected via double staining of CD31 and PAS.RESULTS Negative expression of vWF was detected in all normal thyroid tissue,and weak expression in 5cases of papillary thyroid carcinoma（7.90%）.In contrast,positive expression was detected in 31cases（49.20%）of anaplastic thyroid carcinoma.The differences of the expressional levels among the groups were statistically significant（χ^2=26.289,P〈0.001）.The expressional level of vWF in anaplastic thyroid carcinoma was not related to the gender or age of the patients,size of the tumour or metastas of lymph node,while it was correlated with the distant metastasis and clinical stage（χ^2=5.341,P=0.021;χ^2=4.753,P=0.029）.The positive rates of VM in normal tissue,PTC and ATC were 0,3.20% and 34.92%,respectively,with a significant difference among the groups（χ^2=20.588,P〈0.001）.The formation of VM was closely correlated with the size of the tumour,metastas of lymph node,distant metastasis and clinical stage（χ^2=4.789,P=0.029;χ^2=5.684,P=0.028;χ^2=4.722,P=0.030;χ^2=5.777,P=0.061）.vWF was positively correlated with vasculogenic mimicry（r = 0.411,P=0.001）.CONCLUSIONS The findings of our study indicate that vWF is highly expressed in anaplastic thyroid carcinoma,and its high expression is positively related to the high formation of VM.High expression of vWF may be one of the factors leading to poor prognosis of anaplastic thyroid carcinoma.It is of significance to study the expression and mechanism of vWF in anaplastic thyroid carcinoma to improve the prognosis of patients.