VEGF与星形细胞瘤血管生成和瘤周脑水肿的相关性研究

Vascular endothelial growth factor and the angiogenesis and peritumorous brain edema in astrocytomas

目的 探讨星形细胞瘤的血管内皮细胞生长因子 (VEGF)表达与血管生成和瘤周脑水肿 (PTBE)及病理分级的关系。方法 术前进行MRI检查且经手术病理证实的 3 4例星形细胞瘤患者。在MRI计算星形细胞瘤的瘤体体积和瘤周脑水肿体积 ,从瘤周脑水肿与肿瘤本身的体积之比获得水肿指数 (EI) ,估价脑水肿的程度。采用免疫组化方法 (SP法 )检测3 4例星形细胞瘤VEGF表达 ;Ⅷ因子相关抗原单克隆抗体免疫组织化学 (SP法 )染色显示微血管 ,测量微血管密度 (MVD)表示肿瘤血管生成。结果 VEGF表达与脑星形细胞瘤的血管生成、瘤周脑水肿均呈显著正相关 (r =0 .77,P <0 .0 0 1;r =0 .3 3 6,P =0 .0 5 ) ;高级别星形细胞瘤VEGF、MVD、EI分别显著高于低级别星形细胞瘤 (t =7.0 8,3 .3 7,2 .74;P =0 .0 1,0 .0 11,0 .0 2 5 )。结论 VEGF可能通过参与星形细胞瘤血管生成和脑水肿发生 ,对胶质瘤的恶性演进起促进作用 ;MRI瘤周脑水肿征象能间接反映星形细胞瘤的肿瘤血管形成和预测星形细胞瘤的恶性程度。

Objective To investigate the expression of vascular endothelial growth factor (VEGF) and its relationship with angiogenesis and peritumorous brain edema (PTBE) and with its pathologic grading in astrocytoma.Methods Thirty-four patients with astrocytomas were examined by MRI and proved by surgery and pathology.The volume of tumor and the extent of PTBE were determined on MRI.Edema index (EI),which is the ratio of the volume of PTBE to that of tumor was used to estimate the extent of peritumorous brain edema.Expression of VEGF were examined by immunohistochemical method of streptavidin-biotin-peroxidase (SP).The vascular development was measured by micro-vascular density (MVD) which was immunostained with anti-factor Ⅷ-related antigen monoclonal antibody.Results Both of the angiogenesis and PTBE in astrocytoma were found significantly correlated to the expression of VEGF (r=0.77,P<0.001;r=0.336,P=0.05,respectively).The expression of VEGF,MVD and EI in high-grade astrocytomas were significantly higher than that in low-grade astrocytomas (t=7.08,3.37,2.74;P=0.01,0.011,0.025,respectively).Conclusion VEGF may contribute to the progression of glioma by playing an important role in leading to both angiogenesis and brain edema.The signs of PTBE on MRI may indirectly reflect the angiogenesis of astrocytoma and predict its malignant degree.