胃癌血管形成和肿瘤细胞增殖的关系及其临床意义

目的探讨胃癌血管形成和肿瘤细胞增殖能力的相关性及这两项指标与临床病理特征和预后之间的关系。方法用免疫组织化学ＡＢＣ法，采用抗Ⅷ因子相关抗原的（ａｎｔｉＦⅧＲＡｇ）单克隆抗体进行微血管内皮细胞染色，用ＰＣＮＡ单克隆抗体（ＰＣ１０）进行肿瘤细胞增殖核抗原的染色。分别计数１１６例胃癌中的微血管密度（ＭＶＤ）和ＰＣＮＡ指数，分析它们与临床病理因素及预后的关系。结果ＭＶＤ与胃癌的淋巴结转移（Ｐ＜０．０１）、腹腔内转移（Ｐ＜０．０１）有关，且随ＴＮＭ分期而增加（Ｐ＜０．０１）；ＰＣＮＡ指数与浆膜浸润（Ｐ＜０．０５）、淋巴结转移（Ｐ＜０．０１）、腹腔内转移（Ｐ＜０．０５）有关，Ⅳ期肿瘤中ＰＣＮＡ指数明显高于Ⅰ期肿瘤（Ｐ＜０．０１）。ＭＶＤ与ＰＣＮＡ指数呈正相关（ｒ＝０．３５，Ｐ＜０．０１）。低ＭＶＤ组（ＭＶＤ＜２３）和低ＰＣＮＡ组（ＰＣＮＡ＜４８）的５年总体生存率均分别明显高于高ＭＶＤ组（ＭＶＤ≥２３）和高ＰＣＮＡ组（ＰＣＮＡ≥４８）的５年总体生存率（均Ｐ＜０．０１）。多因素分析表明，ＭＶＤ和ＰＣＮＡ指数均是独立的预后因素。结论胃癌组织中的ＭＶＤ和ＰＣＮＡ指数能反映胃癌的恶性程度，是判断预后和指导辅助治疗的有效指标。

The relationship between tumor angiogenesis and proliferation in gastric carcinoma and their clinical significances

Objective To evaluate the correlation between tumor angiogenesis and proliferation in gastric carcinoma and their relationships with clinicopathologic characteristics and prognosis. Methods One hundred and sixteen specimens resected from the patients with gastric carcinoma were investigated by immunohistochemical techniques with the monoclonal antibodies against F RAg and PCNA. The intratumoral microvessel density (MVD) and PCNA index were counted and their relationship with clinicopathologic factors and prognosis were analyzed. Results The MVD was correlated with lymph node metastasis(P<0.01) and intraabdominal metastasis(P<0.01) and increased with the TNM staging (P<0.01). PCNA index was correlated with serosal involvement (P<0.05), lymph node metastasis(P<0.01) and intraabdominal metastasis(P<0.05). The PCNA index was significantly higher in stage than that in stage (P<0.01). The MVD was also correlated with PCNA index(r=0.35,P<0.01). The total fiveyear survival rates of low MVD group and low PCNA group were significantly higher than that of high MVD group and high PCNA group, respectively (both P<0.01). Multivariate analysis indicated that MVD and PCNA index were independent prognostic factors. Conclusion The MVD and PCNA index can reflect the malignant degree of gastric carcinoma. They may serve as prognostic factors and guide in decision of giving additional therapies.