血管内皮生长因子表达与肝癌患者临床病理特征及预后的关系研究

Relationship between vascular endothelial growth factor expression and clinicopathologic features of patients with hepatocellular carcinoma

目的:研究肝细胞肝癌(HCC)组织中血管内皮生长因子(VEGF)表达与患者临床病理特征及预后的关系。方法:采用免疫组织化学染色法检测79例在广西医科大学附属肿瘤医院行肝癌根治性切除术的HCC患者癌组织中VEGF的表达情况,分析VEGF表达与树突状细胞(DC)浸润程度、肿瘤大小、癌栓、包膜、血清AFP水平及术后肝外转移的关系,随访患者术后生存情况及肿瘤复发情况。结果:79例HCC患者中,VEGF低表达43例(54.4%),高表达36例(45.6%)。VEGF表达与DC浸润程度、肿瘤直径及血清AFP水平有关(P<0.05),与年龄、性别、肿瘤分化程度、包膜完整性、有无癌栓、术后远处转移情况无关(P>0.05)。VEGF高表达组2年内复发率为83.3%(30/36),明显高于VEGF低表达组的60.5%(26/43),差异有统计学意义(P<0.05)。VEGF高表达组平均生存时间为(34.33±4.60)个月,VEGF低表达组平均生存时间为(35.30±3.90)个月,差异无统计学意义(P>0.05)。结论:VEGF与癌组织DC浸润程度、肿瘤直径及血清AFP水平有关,其在HCC组织中高表达可能增加肝癌术后短期复发风险,可作为肝癌早期复发预警指标。

Objective：To study the relationship between the expression of vascular endothelial growth factor（VEGF）and clinicopathologic features and prognosis of patients with hepatocellular carcinoma（HCC）.Methods：VEGF protein expression was examined by immunohistochemistry in tumor tissues from 79 HCC patients undergoing curative resection.Furthermore,the relationships between VEGF expression and clinicopathologic features or postoperative survival of HCC patients were evaluated.Results：Low VEGF expression was detected in 54.4%（43/79）of patients with HCC,and high expression was detected in 45.6%（36/79）of patients.VEGF expression was significantly correlated with degree of dendritic cell（DC）infiltration,tumor size,and serum AFP level（P〈0.05）,but not with age,gender,degree of tumor differentiation,integrity of capsule,presence of tumor thrombus,and postoperative distant metastasis（P〈0.05）.Patients with high VEGF expression had higher 2-year recurrence rate than patients with low VEGF expression（83.3%vs.60.5%）（P〈0.05）.No significant difference in mean survival time between the high and low VEGF expression groups[（34.33±4.60）months vs.（35.30±3.90）months,P〈0.05].Conclusion：VEGF expression was correlated with DC infiltration,tumor size and serum AFP level in HCC patients.High VEGF expression might increase the risk of postoperative recurrence.It suggested that VEGF could be an indicator of early recurrence in HCC.