原发性食管癌中胸苷磷酸化酶表达和血管生成的临床意义

Thymidine Phosphorylase Expression and Angiogenesis in Primary Esophageal Carcinoma

目的 观察原发性食管癌中胸苷磷酸化酶 (thymidinephosphorylase,TP)的表达情况 ,探讨肿瘤组织中胸苷磷酸化酶表达、肿瘤微血管密度 (microvesseldensity ,MVD)和临床病理特征之间的关系 ,分析TP表达和肿瘤MVD的预后意义。方法 应用单克隆抗体对 6 5例食管癌标本进行免疫组化染色 ,测定TP表达及MVD。结果 TP在食管癌中的表达 (4 5 / 6 5 ,6 9.2 % )明显 (P <0 .0 0 1)高于正常食管粘膜 (4 / 2 4 ,16 .7% )。食管癌的MVD(4 5 .0 9± 8.76 )与正常食管粘膜的MVD(2 7.4 8± 8.4 4 )的差别显著 (P <0 .0 0 1)。食管癌TP阳性的MVD的均值是 (4 6 .5 3± 7.18) ,TP阴性的MVD的均值是 (4 1.85± 11.0 8) ,前者明显 (P =0 .0 4 6 ) 高于后者。食管癌的TP表达与临床病理特征无相关性 ,MVD却与肿瘤的浸润深度(P =0 .0 35 ) 及分期(P =0 .0 18) 有关 ,而且只有MVD才是食管癌的一个预后指标(P <0 .0 0 1)。结论 食管癌的TP表达与MVD密切相关。TP表达与食管癌的临床病理特征无关。MVD与肿瘤的浸润发展有关 。

Objective In order to investigate the practical role of thymidine phosphorylase (TP) and angiogenesis in the progression of esophageal carcinoma, and to evaluate whether microvessel density (MVD)and TP expression are independent prognostic factors, TP expression and tumor MVD in primary esophageal carcinoma had been detected, and their association with clinicopathologic parameters had been studied. Methods Immunohistochemical staining using monoclonal antibodies was used to quantify microvessel and TP expression in archival tissue specimens from 65 patients with esophageal squamous cell carcinoma (ESCC). Results TP was expressed significantly more frequently (P<0.001) in ESCC (45 of 65,69.2%) than in adjacent nonneoplastic esophageal tissue samples (4 of 24,16.7%). MVD were significantly higher (P<0.001) in ESCC (45.09±8.76) than in adjacent nonneoplastic esophageal tissue samples (27.48±8.44).Mean MVD was 46.53±7.18 in the TP-positive cases and 41.85±11.08 in TP-negative cases, the value being significantly higher in the former (P=0.046). No significant correlations were observed between TP-expression and clinicopathologic findings. But increased MVD were associated with the depth of tumor invasion (P=0.035) and tumor grade (P=0.018), and only MVD was a predictor of survival. Conclusions This study indicated that in ESCC TP expression is associated with MVD, but TP expression was not correlated with clinicopathologic findings. MVD was correlated with clinicopathologic parameters regarding tumor progression. And only MVD is a prognostic indicator in patients.