结直肠癌微血管、淋巴管以及血管生成拟态与其临床病理特征的关系

Relationship between microvessels, lymphatic vessels, vasculogenic mimicry of colorectal carcinoma and its clinicopathological features

目的研究结直肠癌中微血管密度(MVD)、淋巴管密度(LVD)和血管生成拟态(VM)与其临床病理特征的关系。方法选取广州市增城区人民医院2015年3月至2017年12月期间手术切除的结直肠癌标本77例作为研究对象,用免疫组织化学CD34染色检测MVD,免疫组织化学D2-40染色检测LVD,利用CD34和PAS双重染色检测VM,分析MVD、LVD和VM与结直肠癌临床病理特征之间的关系。结果结直肠癌浸润边缘的MVD为45.1±19.7,明显高于正常结直肠组织的30.4±11.2;结直肠癌浸润边缘的LVD为42.5±15.6,明显高于正常结直肠组织的21.6±12.3,差异均有统计学意义(P<0.05);结直肠癌浸润边缘的MVD平均值在不同肿瘤大小、肿瘤分化程度、临床分期以及有无神经侵犯间的两两比较,差异均有统计学意义(P<0.05);有淋巴结转移者的肿瘤浸润边缘的LVD为52.5±21.8,明显高于无淋巴结转移者的30.1±16.4,差异有统计学意义(P<0.05);LVD在不同年龄、性别、肿瘤分化程度、肿瘤大小、临床分期患者中比较,差异均无统计学意义(P>0.05);结直肠癌组织中出现VM的例数在不同肿瘤大小、肿瘤分化程度、临床分期以及有无神经侵犯者间比较差异均有统计学意义(P<0.05);相关性分析结果显示,MVD、LVD与VM呈显著密切正相关(r均>0.5,P<0.01)。结论结直肠癌中MVD、LVD和VM与其不良临床病理特征有密切关系,对判断结直肠癌侵袭、转移乃至预后可能有重要意义。

Objective To study the relationship between microvessel density (MVD), lymphatic vessel density (LVD), vasculogenic mimicry (VM) and its clinicopathological features in colorectal carcinoma (CRC), and provide reference for clinical diagnosis and treatment. Methods Seventy-seven cases of colorectal cancer specimens surgically resected from March 2015 to December 2017 in Zengcheng District People's Hospital of Guangzhou were selected as subjects. MVD was detected by immunohistochemical CD34 staining, LVD was detected by immunohistochemical D2-40 staining, and VM was detected by VM34 and PAS double staining. The relationship between MVD, LVD and VM and clinicopathological features of colorectal cancer was analyzed. Results The MVD of the invasive edge of colorectal cancer was 45.1±19.7, which was significantly higher than 30.4±11.2 of normal colorectal tissue. The LVD of the infiltrating edge of colorectal cancer was 42.5±15.6, which was significantly higher than 21.6±12.3 of normal colorectal tissue (P<0.05);the mean value of MVD in the invasive edge of colorectal cancer was compared between different tumor size, tumor differentiation degree, clinical stage and presence or absence of neurological invasion, and all the differences were statistically significant (P<0.05). The LVD of the tumor infiltration margin was 52.5±21.8, which was significantly higher than 30.1±16.4 of non-lymph node metastasis (P<0.05);LVD had no significant difference in age, gender, tumor differentiation, tumor size, clinical stage, etc (P>0.05);the number of VMs in colorectal cancer tissues was compared in different tumor size, tumor differentiation degree, clinical staging and presence or absence of neurological invasion, and all the differences were statistically significant (P<0.05). Correlation analysis showed that MVD, LVD and VM were significantly positively correlated (P<0.01). Conclusion MVD, LVD and VM in CRC tissues are closely related to the adverse clinicopathological features of CRC, which may be important for judging the invasion, metastasis and even prognosis of CRC.