膀胱移行细胞癌微血管密度与组织学分级及预后的关系

The Relation of Microvascular Length Density to Histopathological Grading and Prognosis in Transitional Cell Carcinoma of Urinary Bladder

为探讨肿瘤血管形成及其密度与膀胱移行细胞癌生物学行为的关系，应用免疫组化方法检测了67例膀胱移行细胞癌组织第Ⅷ因子相关抗原表达和肿瘤微血管的长度密度（LV）、结果显示，膀胱癌组织中微血管LV明显比正常膀优高（P＜0．01）。但高分化膀胱癌微血管LV与正常膀胱无显著性差异（P＞0.05）。膀胱癌分化越差，微血管LV越高；有肌层浸润组微血管LV明显高于无肌层浸润组（P＜0．01）；术后肿瘤复发组微血管LV显著高于未复发组（P＜0.01），5年死亡组微血管LV显著高于5年生存组（P＜0.01）。结果提示微血管LV与膀胱移行细胞癌的组织学分级和预后密切相关，其肿瘤是典型的血管依赖性病变，血管形成有利于肿瘤生长，浸润及复发。

In order to study the relationship between tumor vascularization, its density and the biologicial behavior of transitional cell carcinoma of urinary bladder,the expression of factor VM related antigen in 67 cases of transitional cell carcinoma of the bladder was examined by immunohistochemical methods and the length density (LV) of microvessels of the tumor was calculated applying biological stereology. The results showed that the microvascular LV in tissue of transitional cell carcinoma was significantly higher than that in normal bladder(P< 0. 01) but no significant difference was found in that between highly differentiated bladder carcinoma and normal bladder (P > 0. 05 ). The less differentiated bladder carcinoma the higher its microvascular LV; and significantly higher microvascular LV existed in tumors with muscular infiltration than in those without (P<0. 01),in patients with recurrence than in those without (P < 0. 01 ), in patients died within 5 years than in those with 5 years survival (P < 0. 01 ). All these suggest that microvascular LV is closely related to the histopathological grading and prognosis of bladder transitional cell carcinoma. The pathological changes in the tumor is typically vessel - dependent and vascularization is favorable to tumor growth infiltration and recurrence.