食管鳞癌微血管密度检测的临床意义

Determination of microvessel density in patients with esophageal squamous cell carcinoma

目的 评价食管鳞癌组织内微血管密度与肿瘤进展和预后之间的关系。方法 采用免疫组化法检测 72例手术切除的食管鳞癌组织的微血管密度并对其与常见临床病理因素和预后之间的关系进行回顾性分析。结果 全组病例微血管密度值为 2 3 .74± 9.49/ 2 0 0倍视野 ,N1组、姑息性切除组、术后复发转移组和Ⅲ期 +Ⅳ期患者的微血管密度分别高于N0 组、根治性切除组、无复发转移组和Ⅱ期患者 (P <0 .0 5 ) ,高微血管密度组的术后生存曲线较低微血管密度组恶劣 (Logranktest ,P <0 .0 5 )。多因素分析表明微血管密度是影响预后的独立因素。 结论 血管形成可促进食管鳞癌的进展 ,并导致术后复发转移率升高及生存率下降 ,检测微血管密度具有判断术后复发转移的风险及预后的价值。

Objective To evaluate the relationship between the microvessel density (MVD) and the progression of esophageal squamous cell carcinoma,and its effect on prognosis.Methods Tissue sections of surgically resected specimens from 72 patients with esophageal squamous cell carcinoma were immunostained with a monocolonal antibody against factor Ⅷ related antigen and the numbers of microvessel were counted under conventional light microscopy at 200× magnification.The relationships between the MVD and sex,age,tumor size,invasive depth,lymph node staus,differentiation degree and survival were analysized,retrospectively.Results The mean value of MVD of the groups was 23.74±9.49/200×magnified field,and the MVD of N 1 group,stage Ⅲ+Ⅳ group,palliative resection group were higher than those of N 0 group,stage Ⅱ group and radical resection group,respectively(P<0.05).The MVD in patients with postoperative recurrence was higher than that of patients without postoperative recurrence.The Kaplan Meier survival curve in patients with low MVD was better than that in patients with high MVD (Log Rank test,P<0.05).Conclusion Angiogenesis plays an important role in the progression of esophageal squamous cell carcinoma,and MVD may be an optimal predictor on determining the risk of postoperative recurrence and judging the prognosis.