脊柱转移癌新生血管形成与预后关系

Correlation between angiogenesis and prognosis in patients with spinal metastasis cancer

目的 :探讨新生血管形成和脊柱转移癌预后之间的关系。方法 :应用免疫组化技术 ,检测 77例人脊柱转移癌组织血管内皮细胞生长因子 (vascular endothelial cell growth factor,VEGF)、VEGF受体 1(flm s- like tyrosine kinase,FL T)、VEGF受体 2 (kinase insertdomain containing receptor,FL K- 1)表达和微血管密度 (microvessels density,MVD)计数。采用 Spearm an等级相关判断 VEGF、FL K- 1、FL T表达之间及与 MVD计数之间的关系 ,以 COX回归分析判别 VEGF、FL K- 1、FL T表达与预后的关系。 结果 :VEGF、FL T、FL K- 1主要表达于转移癌细胞。新生血管形成多位于转移癌的侵袭性边缘。MVD计数 4 .2～ 5 6 .4 (2 1.6 3± 10 .95 )个。FL K- 1、FL T、VEGF表达和 MVD计数之间均呈显著正相关 (P<0 .0 1)。平均随访时间 15 .6个月(5 .2～ 36个月 ) ,3年生存率为 6 .98%。COX回归分析表明 VEGF、FL K- 1表达及 MVD计数为影响脊柱转移癌患者预后的重要因素 (P<0 .0 5 ,P<0 .0 1) ,其中 VEGF表达上调对患者生存的影响最大。 结论

Objective:To investigate the correlation between the angiogenesis and the prognosis in patients with metastasis cancer in spine (PMCS ). Methods: The expression of vascular endothelial cell growth factor(VEGF),flms like tyrosine kinase(FLT),kinase insert domain containing receptor(FLK 1) and microvessels density(MVD) count were studied by using the immunohistochemical method,its relation with prognosis were analyzed by Cox model in 77 PMCS. Results:VEGF, FLT and FLK 1 predominantly expressed in cancer cells. Angiogenesis was significantly higher near invasive edge of metastasis cancers. The mean MVD count was 21.63±10.95 (4.2 56.4), the expression of VEGF,FLT and FLK 1 was significantly correlated with MVD count ( P < 0.01). The postoperative survival rate at 3 years intervals was 6.98% with a mean of 15.6 months follow up(5.2 36 months). The COX regression analysis has shown the expression of VEGF,FLK 1 and MVD count was the important factors influencing the prognosis of PMCS. Conclusion: The angiogenesis has significant influence on the prognosis of PMCS.