胃癌组织中血管拟态生成及其临床意义

Expression of Vascular Mimicry in Gastric Cancer and Its Clinical Significance

目的研究胃癌组织中血管拟态(Vascular Mimicry,VM)生成在胃癌患者预后评估中的预测价值。方法应用CD34/PAS对130例胃癌患者的胃癌组织标本及胃粘膜标本进行免疫组化双染,对比胃癌组织及胃粘膜组织中VM生成差异;分析胃癌组织中VM生成与临床病理参数之间的关系;Kaplan-Meier生存函数分析胃癌组织中VM生成与患者5年总体生存率及无复发生存率的影响;多因素回归分析用于分析影响胃癌患者预后的独立因素。结果 VM样结构仅见于胃癌组织中,胃粘膜组织中未见VM样结构,两组差异有统计学意义(P<0.01);胃癌组织中VM生成与肿瘤大小、肿瘤分化程度,肿瘤侵袭深度,TNM分期,胃周淋巴结转移及脉管中有无癌栓均相关(P均<0.05);Kaplan-Meier分析显示,OS及DFS差异有高度统计学意义(均P<0.01);COX模型多因素回归分析结果表明:胃癌TNM分期、肿瘤分化、脉管内有无癌栓及VM生成状态是影响患者总体生存率的独立预后因素。结论胃癌组织中的VM样结构生成是胃癌根治术后预后不良的指标,血管拟态样结构是胃癌靶向治疗的新靶点。

Objective To evaluate the roles of vascular mimicry(VM)in the prognosis in gastric cancer.Methods CD34/PAS immunohistochemical double staining was used to detect the expression of VM in the tumor tissues and gastric mucosa tissues in 130 gastric cancer patients who received radical resection.The relationship between the expression of VM in the tumor tissues and clinical pathological parameters was analyzed,postoperative follow⁃ing-up was performed for 5 years and survival was observed.Multivariate regression analysis was used to analyze the independent risk prognostic factor of gastric cancer patients.Results VM is found only in gastric cancer tis⁃sues,there was significant difference between the tumor tissues and gastric mucosa tissues(P<0.01).VM in gastric cancer was associated with tumor size,tumor differentiation,invasion depth,TNM stage,lymph node metastasis,and tumor emboli in the microvessels(all P<0.05).The overall survival(OS),the disease-free survival(DFS)time between two groups were significant(all P<0.01).Multivariate regression analysis found the TNM stage,tu⁃mor differentiation,and the expression of VM were the independent risk factors for the overall survival of the pa⁃tients with gastric cancer.Conclusion The expression of VM in gastric cancer tissues is an indicator of poor prog⁃nosis,which is a new therapy target for gastric cancer.