胆管细胞性肝癌的血管新生及临床病理意义

目的目前关于胆管细胞性肝癌(CCC)的血管新生研究较少,本研究的目的在于描述CCC的血管新生的特点,其与血管新生调控因子之间的关系以及临床-病理意义.方法调查33例手术切除的CCC标本.肿瘤微血管密度(MVD)使用抗CD34抗体进行标记,并进行了VEGF Ang-1 Ang-2 and TSP-1的免疫组化染色.结果本组CCC的MVD为(87.2±52.6),范围为10-229.VEGF Ang-1 Ang-2和TSP-1的阳性率分别为75.6%,36%,57.6%和45.5%.VEGF和Ang-2的阳性表达与高MVD相关,TSP-1则负相关(P值分别为0.004,0.015和0.005).阳性TSP-1与肝内转移正相关(46.7%vs.5.6%,P=0.012).除此之外,并没有发现VEGF Ang-1Ang-2和TSP-1的阳性表达与肿瘤大小,包膜形成,包膜浸润,门脉侵犯,肝内转移,细胞分化之间的相关性.MVD的高低以及VEGF,Ang-1,Ang-2和TSP-1的阳性表达与根治性切除的23例的术后生存率之间没有发现相关性.结论CCC瘤内的血管新生活跃,其瘤内血管新生与病理类型有一定的关系.VEGF和Ang2的阳性表达与CCC血管新生正相关,TSP-1则与其负相关.TSP-1的阳性表达还与肝内转移正相关,除此此外,并没有发现MVD和VEGF,ANG1,or ANG2的表达与肿瘤的恶性程度或者预后相关.

Angiogenesis in cholangiocellular carcinoma and clinico-pathological significance

Objective] To elucidate the angiogenesis status of CCC, the relationship with well known angiogenic factors and clinico-pathological means. Methods] 33 specimen of surgically resected CCC were investigated. Angiogenesis of tumor was assessed by routine microvessel density counting using anti-CD34 antibody. Immunohistochemical Staining of VEGF Ang-1 Ang-2 and TSP-1 were carried out. Results] The mean MVD is (87.2±52.6),with a ranged of from 10 to 229. VEGF expression is positive in 75.6% cases; Ang-1 expression is positive in 36%cases; Ang2 positive is positive in 57.6% of cases and 45.5% cases exhibited positive TSP-1 expression. VEGF and Ang-2 expression were found to be associated with significant higher level of MVD (P =0.004 and 0.015 respectively). TSP-1 expression was found to be associated with significant low level of MVD (P =0.005). Positive TSP-1 expression was also found to be associated with higher level of intrahepatic metastasis (46.7% vs. 5.6%, P =0.012). Except that, there was no significant correlation between VEGF, Ang-1, Ang-2 and TSP-1expression and tumor size,capsule formation, infiltration of capsule, portal vein invasion, intrahepatic metastasis or differentiation of the CCC has been found. No significant correlation between MVD levels, VEGF, Ang-1, Ang-2, TSP-1 expression and postoperative survival has been found. Conclusion] Considerable angiogenesis comparable to other solid tumors are observed in CCC. VEGF and Ang2 may play a proangiogenic role and TSP-1 may play an inhibitory role. Although TSP-1 may increase the intrahepatic metastasis of CCC, neither MVD levels nor the expression of VEGF, ANG1, or ANG2 is associated with tumor invasiveness and prognosis.