血管内皮细胞生长因子在不同BMI乳腺癌患者中的表达及其对预后的影响

Expression of Vascular Endothelial Growth Factor in Breast Cancer Patients with Different BMI and its Effect on Prognosis

目的:探讨血管内皮细胞生长因子在不同体质量指数乳腺癌患者中的表达及其对预后的影响。方法:入选2016年1月至2017年1月间收治的450例经手术治疗符合条件的女性乳腺癌患者为研究对象,根据身体质量指数分为正常体质量组(18kg/m^2<BMI<25kg/m^2)和肥胖组(BMI≥25kg/m^2)。采用标准链霉菌抗生物素蛋白-过氧化物酶亲和免疫组化方法检测研究对象癌组织中的血管内皮细胞生长因子,依组织中阳性细胞数比值将其分为4级:无阳性细胞为阴性(-);阳性细胞<20%为低度表达(+);阳性细胞20%~50%为中度表达(++);阳性细胞>50%为高度表达(+++)。-^+视为血管内皮细胞生长因子低度表达,++^+++为血管内皮细胞生长因子高度表达。所有研究对象术后均随访2年,记录随访期间研究对象是否发生复发转移。结果:身体质量指数正常组血管内皮细胞生长因子的强表达率为38.9%,肥胖组血管内皮细胞生长因子强表达率为75.4%。身体质量指数正常组患者中,VEGF高表达的患者与VEGF低表达的患者相比,2年无病生存期的差异没有统计学意义(P>0.05)。肥胖乳腺癌组患者中,VEGF高表达的患者比VEGF低表达的患者2年无病生存期短,差异有统计学意义(P<0.05)。肥胖乳腺癌组VEGF低表达的患者与身体质量指数正常组VEGF低表达的患者相比,2年无病生存期的差异有统计学意义,(P<0.05)。肥胖乳腺癌组VEGF高表达的患者与身体质量指数正常组VEGF高表达的患者相比,2年无病生存期的差异也有统计学意义,(P<0.05)。结论:血管内皮细胞生长因子在肥胖乳腺癌患者中的表达增多,其表达水平与乳腺癌的预后显著相关,提示超重和肥胖的乳腺癌患者应积极控制体重,防止乳腺癌的复发和转移。

Objective:To investigate the expression of vascular endothelial growth factor in breast cancer patients with different body mass index and its effect on prognosis.Methods:450 cases of female breast cancer patients who met the criteria for surgical treatment from January 2016 to January 2017 were selected as the study subjects.They were divided into the normal body mass index group(18 kg/m^2<BMI<25kg/m^2)and the obesity group(BMI≥25kg/m^2)according to their body mass index.Vascular endothelial cell growth factor(VEGF)was detected by standard streptomycetin protein-peroxidase affinity immunohistochemistry in cancer tissues of subjects,and was divided into 4 levels according to the ratio of positive cells in the tissues:No positive cells are negative(-);Positive cells<20%showed low expression(+).20%~50%of the positive cells were moderately expressed(++)>50%of the positive cells were highly expressed(+++).-^+was regarded as low expression of vascular endothelial growth factor,while++^++was highly expressed.All subjects were followed up for 2 years postoperatively,and whether the subjects had recurrence or metastasis during the follow-up period was recorded.Results:The expression of vascular endothelial growth factor(VEGF)was 38.9%in the normal BMI group and 75.4%in the overweight and obese groups.In the patients with normal BMI,there was no statistically significant difference in 2-year disease-free survival between the patients with high VEGF expression and those with low VEGF expression(P>0.05).In the overweight and obese breast cancer group,the 2-year disease-free survival period of the patients with high VEGF expression was shorter than that of the patients with low VEGF expression,and the difference was statistically significant(P<0.05).Compared with the patients with low VEGF expression in the normal BMI group,the difference in 2-year disease-free survival was statistically significant in the overweight and obese breast cancer group(P<0.05).Compared with patients with high VEGF expression in the normal BMI group,patients with high VEGF expression in the overweight and obese breast cancer group also had a statistically significant difference in 2-year disease-free survival(P<0.05).Conclusion:The expression of vascular endothelial growth factor(VEGF)is increased in obese breast cancer patients,and its expression level is significantly correlated with the prognosis of breast cancer,which suggests that overweight and obese breast cancer patients should actively control their weight to prevent recurrence and metastasis of breast cancer.