胃癌及癌前病变中血管内皮生长因子C的表达及意义

目的　探讨血管内皮生长因子C(vascularendothelialgrowthfactor C ,VEGF C)在胃癌前病变和胃癌中的表达及与淋巴转移的关系。方法　采用免疫组织化学染色 ,观察 2 0例胃上皮内瘤变组织和 5 0例胃癌VEGF C表达。结果　 (1)VEGF C可在一些肠上皮化生组织、倾向上皮内瘤变的肠上皮化生组织以及上皮内瘤变组织的胞浆染色 ,上皮内瘤变组织VEGF C染色阳性率为 6 5 % (13/2 0 )。 (2 )原发胃癌中 ,4 4例胃腺癌VEGF C染色阳性率为75 % (33/44 ) ,6例印戒细胞癌未见明显VEGF C染色 ,高、中分化腺癌VEGF C染色通常强于低分化腺癌 ,但后者与淋巴结转移间差异有显著性 (P <0 .0 5 )。VEGF C表达与年龄、浸润深度、淋巴结转移及淋巴管浸润间差异有显著意义 (P <0 .0 5 ) ,但与远处转移、临床分期、肝转移以及静脉浸润间差异无显著意义 (P >0 .0 5 )。淋巴结转移组VEGF C表达率明显高于无淋巴结转移组 (P =0 .0 11)。结论　胃肿瘤前病变和胃癌细胞均可分泌VEGF C ,VEGF C可能通过促进淋巴管生成对胃癌淋巴结转移发挥重要作用

Expression and Significance of Vascular Endothelial Growth Factor C in Gastric Cancer and Pre-cancerous Lesion

Objective To investigate the expression and significance of vascular endothelial growth factor C (VEGF-C) in gastric cancer and pre-cancerous lesion and the relationship between VEGF-C expression and lymphatic metastasis.Methods The expression of VEGF-C was detected in 20 intraepithelial neoplasia and 50 gastric cancer by using immunohistochemistry.Results (1) VEGF-C can be stained in cytoplasm in some intestinal metaplasia,intestinal metaplasia with intraepithelial neoplasia tendency and intraepithelial neoplasia.Of the 20 intraepithelial neoplasia,65%(13/20) showed intense cytoplasmic VEGF-C immunoactivity.(2) Of the 44 gastric adenocarcinomas,33(75%) showed intense cytoplasmic VEGF-C immunoactivity in many cancer cells,but 6 signet-ring cell carcinoma showed very faint VEGF-C immunoreactivity.The VEGF-C staining in tubular adenocarcinomas with well and moderate differentiation and papillary adenocarcinomas was stronger than that of adenocarcinomas with poor differentiation.But the latter had a statistical correlation with lymph node metastasis(-P-<0.05).VEGF-C expression was closely related with histological grade,invasive depth,lymph node metastasis and lymphatic invasion(-P-<0.05),but no association with distant metastasis,clinical stage,liver metastasis and venous invasion(-P->0.05).The incidence of VEGF-C expression in patients with lymph node metastasis was higher than those with no lymph node metastasis.Conclusion VEGF-C can be secreted in all precancerous lesions and primary gastric carcinoma.VEGF-C might play an important role in lymph node metastasis of gastric carcinoma via lymphangiogenesis.