宫颈癌血管内皮生长因子表达与血管生成癌细胞增殖及侵袭转移的关系

Relationship between expression of VEGF and angiogenesis,cancer cell proliferation,invasion and metastasis in invasive carcinoma of cervix

目的 研究血管内皮生长因子 (VEGF)在早期宫颈癌的表达和临床意义。方法 采用免疫组织化学SP法检测 1998年 1月至 2 0 0 2年 2月期间 75例早期宫颈癌 (ICC)、18例宫颈上皮内瘤样病变 (CIN)和 15例癌旁正常宫颈上皮 (NCE)中VEGF的表达情况 ,并检测其中微血管密度 (MVD ,CD3 4 标记 )和癌细胞增殖标记指数 (Ki 6 7标记 )。结果 从NCE→CIN→ICC ,VEGF、Ki 6 7的阳性表达率和MVD均显著升高 (P <0 0 5 )。VEGF在ICC的表达与MVD显著正相关 (r =0 6 0 2 ,P <0 0 1) ,与盆腔淋巴结转移、脉管浸润、组织学分级和Ki 6 7表达显著相关 (P <0 0 5 ) ,但与年龄、FIGO分期、组织学类型和间质浸润无关 (P >0 0 5 )。低分化、盆腔淋巴结转移、脉管浸润及Ki 6 7高度表达者 ,与VEGF阳性表达显著相关 (P <0 0 5 )。结论 VEGF阳性表达可能在宫颈癌血管生成、癌细胞增殖、癌细胞侵袭转移中起重要作用。VEGF检测对进一步了解宫颈癌生物学行为和判断其预后具有一定的临床应用价值。

Objective To investigate the expression of vascular endothelial growth factor (VEGF) in early invasive carcinoma of cervix and its clinical significance.Methods Expression of VEGF protein,microvessel density (MVD) labeled by CD 34 and proliferation index of cancer cells labeled by Ki 67 in 75 cases of early invasive carcinoma of cervix (ICC),18 cases of cervical intraepithelial neoplasm (CIN) and 15 cases of normal cervical epithelium (NCE) remote from tumor were detected by immunohistochemistry SP method during Jan 1998 to Feb 2003.Results MVD and the rates of positive expression of VEGF and Ki 67 increased remarkably from NCE to CIN,and then to ICC,accordingly (P<0 05).In ICC,MVD was positively related to expression of VEGF (r=0 602,P<0 01).There was a significant relationship between the expression of VEGF and pelvic lymph node metastasis,intravascular involvement,histological grading or Ki 67 expression (P<0 05),but no relationship with patients age,FIGO staging,histological types and stroma infiltration (P>0 05).Poor differentiation,pelvic lymph node metastasis,intravascular involvement or over expression of Ki 67 was significantly related to positive expression of VEGF in ICC (P<0 05).Conclusion In cervical carcinoma,positive expression of VEGF may play an important role in tumor angiogenesis,proliferation of cancer cells,cancer invasion and metastasis.Detection of VEGF may be of value in further understanding the biological behavior and predicting the prognosis of cervical carcinoma.