宫颈癌血管生成与癌细胞增殖及浸润转移的关系

Relationships between Angiogenesis and Cancer Cell Proliferation, Invasion and Metastasis in Invasive Carcinoma of Cervix

目的 探讨早期宫颈癌血管生成与癌细胞增殖及浸润转移的关系。方法 采用免疫组织化学 SP法检测75例早期宫颈癌、18例宫颈上皮内瘤样病变 (CIN)和 15例癌旁正常宫颈上皮中微血管密度 (MVD,CD34 标记 )及 Ki- 6 7抗原的表达情况 ,探讨宫颈癌血管生成与癌细胞增殖及浸润转移的关系。结果 CD34 主要表达于宫颈癌巢间质血管内皮细胞 ,而 Ki- 6 7主要表达于宫颈癌细胞核。从正常宫颈上皮→ CIN→宫颈浸润癌 ,MVD和 Ki- 6 7表达均显著升高 (P<0 .0 5 )。宫颈癌 MVD与盆腔淋巴结转移、脉管浸润、间质浸润和 Ki- 6 7表达有关 (P<0 .0 5 ) ;而与年龄、FIGO分期、组织学分级和组织学类型无关 (P>0 .0 5 )。有盆腔淋巴结转移、脉管浸润、≥深层间质浸润及 Ki- 6 7呈高度表达者 ,其 MVD分别显著高于无盆腔淋巴结转移、无脉管浸润、<深层间质浸润及 Ki- 6 7<高度表达者 (P<0 .0 5 )。结论 肿瘤血管生成可能在宫颈癌发生发展、癌细胞增殖和浸润转移中起重要作用。宫颈癌伴 MVD显著升高者 ,其癌细胞增殖活跃 ,易发生浸润转移 ,但并非唯一决定因素。检测宫颈癌 MVD对进一步了解宫颈癌生物学行为具有一定的临床应用价值。

Objective To explore the relationships between angiogenesis in early invasive carcinoma of cervix and cancer cell proliferation,invasion and metastasis.Methods The microvascular densities(MVD,labeled by CD 34 ) and expressions of Ki67 antigen in 75 cases of early invasive carcinoma of cervix,18 cases of cervical intraepithelial neoplasis(CIN) and 15 cases of normal cervical epithelium adjacent to tumor were detected by immunohistochemistry SP method,and the relationship between angiogenesis in invasive carcinoma of cervix and proliferation of cancer cells,cancer invasion and metastasis was analyzed statistically.Results The staining reaction of CD 34 was mainly confined to vascular epithelial cells in tumor stroma,whereas that of Ki 67 was mainly to the nucleus in tumor cells.It showed that the MVDs and the rates of positive expression of Ki 67 increased remarkably in the sequence of norma cervical epithelium,CIN and invasive carcinoma of cervix(P<0.05).There was relationship between the MVD in invasive carcinoma of cervix and pelvic lymphonode metastasis,intravascular involvement,stroma involvement or Ki 67 expression (P<0.05),but no relationship between it and age,FIGO staging,histopathological grading and histopathological involvement,deep stroma involvement or overexpression Ki 67 was significantly higher than that in those without them (P<0.05).Conclusion Tumor angiogenesis might play an important role during the canceration,proliferation of cancer cells,cancer invasion and metastasis in cervical carcinoma. High MVD in invasive carcinoma of cervix might lead to active tumor cells proliferation ,cancer invasion and metastasis ,but it was not the only decisive factor.Dection of MVD might be valuable to further understand the biological behavior of cervical carcinoma.