TSP-1 VEGF MVD判断食管鳞癌患者预后价值的比较

Expression of Thrombospondin-1,Vascular Endothelial Growth Factor and Microvessel Density in Esophageal Squamous Cell Carcinoma:Comparision of their Value on Judging Prognosis

目的:评价TSP-1、VEGF、MVD在判断食管鳞癌患者预后中的价值。方法:采用免疫组化法检测72例食管鳞癌手术切除标本的VEGF、TSP-1蛋白的表达情况并计数MVD,对上述指标与术后中位生存时间、复发转移率以及术后生存率之间的关系进行回顾性分析。结果:全组病例TSP-1、VEGF蛋白表达阳性率分别为30.56%(22/72)和62.50%(45/72);MVD平均值为23.74±9.49/200倍视野;VEGF阳性组的术后复发转移率高于VEGF阴性组,阳性组的中位生存时间、术后生存率低于阴性组(P<0.05);TSP-1阳性组的术后复发转移率低于TSP-1阴性组,阳性组的中位生存时间、术后生存率高于阴性组(P<0.05);术后复发转移组的MVD高于无复发转移组,高MVD组的中位生存时间以及术后生存率低于低MVD组(P<0.05);多因素分析表明,淋巴结状况、手术性质、MVD为影响预后的独立因素(P<0.05)。结论:MVD是影响食管鳞癌预后的独立因素,具有判断术后复发转移的风险及预后的价值。TSP-1、VEGF在判断预后中的价值仍有待于进一步研究。

Objective:To compare the value of the expression of TSP-1protein,VEGF protein and MVD on judging prognosis in esophageal squamous cell carcinoma.Methods:The ex-pression of VEGF,TSP-1protein in72resected specimens from patients with esophageal squamous cell carcinoma was examined immunohistochemically,and the microvessel density was counted.The relationships between TSP-1,VEGF as well as MVD with postoperative recurrence /metastasis rate,median survival time(MST)and postoperative survival rate was analysized retrospectively.Results:45of the72(62.50%)patients studied were positive for VEGF expression.The VEGF-positive patients were more likely to occur postoperative recurrence /metastasis than VEGF-negative pa-tients,the medium survival time(MST)and postoperative survival rate were lower in VEGF-posi-tive groups than in VEGF-negtive groups(P<0.05).Altogether22out of the72(30.56%)specimens were found positive for TSP-1staining.The postoperative recurrence /metastasis rate of TSP-1positive patients was lower than that of TSP-1negative patients,the MST and postoperative sur-vival rate of TSP-1positive patients were higher than those of TSP-1negative patients (P<0.05).The mean value of MVD of the overall group was23.74±9.49/200x.The MVD value in patients with postoperative recurrence /metastasis was higher than that in patients without postoperative re-currence /metastasis,and the median survival and postoperative survival rate of high-MVD patients were lower than those of low-MVD patients(P<0.05).Multivariate analysis showed that lymph node status,operative characteristic and MVD were independent factors that could impact on the prognosis(P<0.05).Conclusion:MVD is an independent factor that may predict the prognosis of esophageal squamous cell carcinoma and it may be helpful in judging the risk of postoperative recurrence /metastasis.The value of the expression of VEGF and TSP-1on judging the prognosis of esophageal squamous cell carcinoma needs further study.