Smad-4与VEGF在膀胱尿路上皮癌组织中的表达及临床意义

目的研究Smad-4和血管内皮生长因子（vascular endothelial growth factor,VEGF）在同一膀胱尿路上皮癌组织中的表达及与膀胱尿路上皮癌临床参数的关系,探讨肿瘤血管形成及调节机制。方法采用免疫组化SP法,检测50例膀胱尿路上皮癌及10例正常对照膀胱组织的石蜡标本中Smad-4和VEGF的表达情况,分析Smad-4和VEGF与病理分级、临床分期和复发等病理参数之间的关系。结果膀胱尿路上皮癌组织中Smad-4的阳性表达率（30.0%）明显低于对照组（80.0%）（P〈0.05）;VEGF的阳性表达率（68.0%）明显高于对照组（10.0%）（P〈0.05）;Smad-4的表达与VEGF的表达呈负相关（P〈0.01）;Smad-4的表达与肿瘤临床分期、病理分级、复发及转移显著相关（P〈0.05）;VEGF的表达与肿瘤临床分期、病理分级、转移显著相关（P〈0.05）,与肿瘤复发无相关性（P〉0.05）。结论 Smad-4、VEGF与膀胱尿路上皮癌的发生、发展、复发及转移密切相关;Smad-4可能参与VEGF的表达调控并影响肿瘤血管生成,其具体机制有待进一步研究。Smad-4可作为判断膀胱尿路上皮癌复发、转移和预后的重要指标。

The expression of Smad-4 and VEGF in human bladder urothelial carcinoma and their clinical significances

Objective To study the expression of Smad4,VEGF in bladder urothelial carcinoma,and its relationship with angiogenesis and clinical significance.Methods The methods of S-P Immunohistochemistry was used to detect the expression of Smad4,VEGF in 50 cases of bladder urothelial carcinoma tissues,10 cases of normal bladder mucosa tissues,and the expression of Smad4,VEGF,was analyzed with relation to clinical stage,pathological grade,recurrence,metastasis and angiogenesis.Results The positive expression of Smad4 in bladder urothelial carcinoma（30.0%） is significantly lower than that in normal bladder mucosa tissues（80.0%,P〈0.05）.The positive expression of VEGF in bladder urothelial carcinoma（68.0%） is significantly higher than that in normal bladder mucosa tissues（10.0%,P〈0.05）.In bladder urothelial carcinoma,the expression levels of Smad4 was negatively correlated with both the expression levels of VEGF（P〈0.01）.In bladderurothelial carcinoma,the expression of Smad4 is significantly correlated with clinical stage,pathological grade,recurrence and metastasis（P〈0.05）,the expression of VEGF is significantly correlated with clinical stage,pathological grade and metastasis（P〈0.05） and independent of recurrence（P〈0.05）.Conclusions We can draw the conclusion that Smad4 and VEGF play important roles in the genesis,development,recurrence and metastasis of bladder urothelial carcinoma.Smad4 perhaps take part in regulating the expression of VEGF and angiosis of bladder urothelial carcinoma,but the specific mechanism still to be investigated.Smad4 could be used as an important marker to indicate the invasion,metastasis and prognosis in bladder urothelial carcinoma.