血管内皮生长因子表皮生长因子受体和人表皮生长因子受体-2在结直肠癌中的表达及其临床意义

目的探讨血管内皮生长因子(VEGF)、表皮生长因子受体(EGFR)及人表皮生长因子受体-2(HER-2)在结直肠癌中的表达及其与临床病理特征的关系和意义。方法采用免疫组织化学法检测结直肠癌、绒毛状腺瘤、管状腺瘤及正常组织中VEGF、EGFR和HER-2的表达,分析各组间表达的差异及其与临床病理参数的关系。结果在结直肠癌、绒毛状腺瘤、管状腺瘤和正常结直肠组织中VEGF的阳性率分别为74%(51/69)、61%(17/28)、27%(4/15)、0(0/15),各组间表达的差异有统计学意义(χ2=33.663,P=0.000);EGFR的阳性率分别为43%(30/69)、21%(6/28)、20%(3/15)、0(0/15),各组间表达的差异有统计学意义(χ2=13.877,P=0.003);HER-2的阳性率分别为17%(12/69)、0(0/28)、0(0/15)、0(0/15),各组间表达的差异有统计学意义(χ2=11.140,P=0.011)。②在结直肠癌,VEGF阳性率与淋巴结转移(χ2=7.442,P=0.006)、分化程度(χ2=5.519,P=0.023)有关,与患者性别(χ2=0.099,P=0.754)、年龄(χ2=1.998,P=0.158)、部位(χ2=0.209,P=0.648)无关;EGFR阳性率与淋巴结转移(χ2=5.113,P=0.024)、分化程度(χ2=4.495,P=0.034)有关,与患者性别(χ2=0.090,P=0.765)、年龄(χ2=0.193,P=0.660)、部位(χ2=1.002,P=0.317)无关;HER-2的表达与患者的性别(χ2=0.451,P=0.502)、年龄(χ2=0.793,P=0.373)、部位(χ2=0.019,P=0.889)、分化程度(χ2=0.721,P=0.396)、淋巴结转移(χ2=0.613,P=0.434)均无关。③VEGF、EGFR和HER-2表达在结直肠癌中表达两两呈正相关(r=0.388,P=0.001;r=0.273,P=0.023;r=0.292,P=0.015)。结论 VEGF、EGFR和HER-2的表达与结直肠癌的发生发展密切相关,VEGF、EGFR和HER-2表达在结直肠癌中表达两两呈正相关,联合检测三者的表达能更准确地评估结直肠癌的生物学特征及预后。

Expression and significance of vascular epithelial growth factor, epithelial growth factor receptor and human epidermal receptor-2 in colorectal carcinoma

Objective To investigate the expression and significance of vascular endothelial growth factor （VEGF）, epidermal growth factor receptor （EGFR） and human epidermal receptor-2 （HER-2） in colorectal carcinoma. Methods Immunohistochemistry was employed to detect the expression of VEGF, EGFR and HER-2 in colorectal carcinoma, villous adenoma, tubular adenoma and normal colorectal tissues. This entailed analysis on the difference and clinieopathologic parameters among all groups. Results The positivity of VEGF expression was 74% （51/69）, 61% （17/28）, 27% （4/15） and 0 （0/15） in colorectal carcinoma, villous adenoma, tubular adenoma and normal colorec- tal tissue （X2=33.663, P=0.000）, respectively. These figures were 43% （30/69）, 21% （6/28）, 20% （3/15） and 0 （0/15） for the positivity of EGFR （X2=13.77,P=-0.003）, as well as 17% （12/69）, 0 （0/28）, 0 （0/15） and 0 （0/15） for the positivity of HER-2 （A,Z=1 1.140, P=0.011）, respectively. In patients with colorectal carcinoma, VEGF expression was related to lymphatic metastasis （X2=7.442, P=0.006） and tumor differentiation （X2=5.519, P=0.023）, but not sex （x^2=0.099, P= 0.754）, age （x^2=1.998, P=0.158） or tumor sites （x^2=0.209, P=0.648）. EGFR expression was associated with lymphatic metastasis （X2=5.113, P=0.024） and differentiation degree （X2=0.495, P=-0.034）, but not sex （X2=0.090, P=-0.765）, age （ x^2=0.193, P=-0.660） or tumor＇s location （A~=l.O02,/9=-0.317）. The expression of HER-2 was not correlated with sex （X2= 0.451, P=-0.502）, age （Xz=0.793, P=0.373）, tumor＇s location （Xz=0.019, P=0.889）, differentiation （X2=0.721,P=-0.396） or lymphatic metastasis （x^2=0.613, P=0.434）. There was a positive correlation between expression of VEGF and EGFR,between VEGF and HER-2 as well as between EGFR and HER-2 in colorectal carcinoma （r=-0.388, P=0.001; r=-0.273, P=0.023; r=0.292, P=0.015）. Conclusion VEGF, EGFR and HER-2 are closely correlated with the pathogenesis of colorectal carcinoma and are positively correlated with each other. Their combination is expected to more accurately evaluate the biological properties and prognosis of colorectal carcinoma.