ET-1和VEGF-C在喉癌中的表达及临床意义

目的：研究血管内皮素-1（ET-1）和血管内皮生长因子-C（VEGF-C）在喉癌组织中的表达规律,探讨两者与喉癌发生、发展和淋巴结转移的关系及在预后中的意义。方法：选择45例经病理确诊的喉癌组织为实验组,20例喉良性病变组织为对照组,免疫组化法和实时荧光定量PCR法检测ET-1和VEGF-C蛋白和mRNA的表达,5＇-核苷酸酶染色法（5＇-Nase）计数淋巴管密度（LVD）,CD34染色计数微血管密度（MVD）,并结合临床病理特征和生存资料进行相关分析。结果：喉癌淋巴结转移组ET-1、VEGF-C蛋白和mRNA表达显著高于未转移组（P〈0.05）,二者均显著高于良性喉组织（P〈0.01）。喉癌组织中ET-1蛋白表达与瘤内和瘤周LVD、MVD、淋巴结转移、淋巴管浸润、TNM临床分期显著相关（P〈0.05）,与年龄、性别、肿瘤部位及组织学分级无关（P〉0.05）。VEGF-C蛋白表达与瘤内和瘤周LVD、淋巴结转移、淋巴管浸润、MVD显著相关（P〈0.05）,与年龄、性别、肿瘤部位、TNM临床分期及组织学分级无关（P〉0.05）。ET-1和VEGF-C在肿瘤组织中的蛋白表达正相关（r=0.456,P=0.001）。生存分析显示ET-1蛋白阳性表达与生存率无关（P〉0.05）,ET-1＋/VEGF-C＋、VEGF-C蛋白阳性表达与生存率负相关（P〈0.05）,其中ET-1＋/VEGF-C＋阳性表达更具有显著高危死亡率（P=0.000）。Cox回归模型显示ET-1＋/VEGF-C＋可以独立影响预后（P〈0.05）。结论：ET-1和VEGF-C均能促进喉癌淋巴管生成和血管生成。在喉癌组织中ET-1过表达可能通过诱导VEGF-C表达上调促进喉癌淋巴管生成和淋巴结转移。联合检测ET-1及VEGF-C的表达可成为判断喉癌预后的新的生物学指标。     

iNOS和VEGF-C的表达与喉癌组织淋巴管生成及预后关系

[目的]探讨诱导型一氧化氮合酶(iNOS)在喉癌组织中的表达与血管内皮生长因子-C(VEGF-C)、淋巴管密度(LVD)、淋巴结转移和预后的相关性。[方法]以45例经病理确诊的喉癌组织为实验组,20例喉良性病变组织为对照组,采用免疫组织化学检测iNOS和VEGF-C的表达,采用5′-核苷酸酶染色(5′-Nase)计数LVD,并结合临床病理特征和生存资料进行相关分析。[结果]喉癌组织中iNOS和VEGF-C的阳性表达率分别为71.1%和37.8%,较对照组显著增加(P<0.05),在喉癌组织中iNOS表达与瘤内和瘤周LVD、淋巴结转移、TNM临床分期、淋巴管浸润有关(P<0.05)。iNOS和VEGF-C表达正相关(r=0.396,P<0.05),iNOS阳性表达者生存率显著低于阴性表达者(P<0.05)。[结论]喉癌组织中iNOS过表达可能通过上调VEGF-C表达促进喉癌淋巴管生成和淋巴结转移,检测iNOS可成为判断喉癌预后新的生物学指标。     

肾细胞癌组织VEGF-C表达与淋巴管生成和淋巴转移的相关性

目的:应用特异的淋巴管内皮标志podoplanin检测肾细胞癌(RCC)组织中淋巴管,用淋巴管密度(LVD)表示淋巴管生成情况, 探讨RCC 内VEGF-C表达与淋巴管生成和淋巴转移的关系.方法:收集45例RCC和10例肾外伤致肾切除的正常肾组织标本,应用免疫组化检测VEGF-C、podoplanin 的表达,计算VEGF-C阳性表达率及淋巴管密度值,分析两者的关系.结果:RCC 组织内VEGF-C 阳性表达率(71.1%) 显著高于正常肾组织(10.0%),P<0.01,高中分化(70.6%) 和低分化(72.7%) 之间差异无统计学意义,P>0.05,淋巴结阳性组中VEGF-C阳性率(81.3 %)显著高于淋巴结阴性组(65.5%),P<0.05.RCC组织内LVD(6.8±1.3) 显著高于正常肾组织(1.2±0.3),P<0.01;VEGF-C阳性组LVD(7.6±1.5)显著高于VEGF-C 阴性组(4.7±0.9),P<0.05, 淋巴结阳性组LVD (8.3±1.4) 显著高于淋巴结阴性组(5.1±1.1),P<0.05.结论:淋巴管生成可能是RCC淋巴结转移的重要因素,VEGF-C参与RCC淋巴管生成,从而促进淋巴结转移.     

鼻咽癌组织VEGF-C和VEGFR-3表达与临床病理因素相关性分析

目的:探讨鼻咽癌(NPC)组织VEGF-C和VEGFR-3的表达,及其和淋巴管密度(LVD)与临床病理参数的关系。方法:采用免疫组织化学PV-9000二步法检测55例NPC患者放疗前活检组织石蜡标本中VEGF-C和VEGFR-3的表达及LVD,分析其与临床病理参数之间的关系。结果:NPC无淋巴结转移组VEGF-C阳性率(61.5%)低于淋巴结转移组(89.7%),P=0.01;无淋巴结转移组VEGFR-3阳性率(73.0%)低于淋巴结转移组(89.7%),P=0.011;无淋巴结转移组LVD(15.2±5.2)低于淋巴结转移组(19.3±6.6),P=0.013。VEGF-C和VEGFR-3的表达与临床分期有关,P<0.001;而VEGF-C和VEGFR-3的表达及LVD与年龄、性别和原发肿瘤T分期无关,P>0.05。VEGF-C和VEG-FR-3均与LVD呈正相关,r值分别为0.491和0.467,P值均为0.000。结论:VEGF-C可促进淋巴管生成和NPC颈淋巴结转移。针对VEGF-C/VEGFR-3信号传导系统的抗淋巴管生成的治疗,有望成为抗NPC淋巴结转移的有效途径。     

非小细胞肺癌VEGF-C表达与淋巴管生成和淋巴转移关系的研究

背景与目的近年来的研究表明,血管内皮生长因子C(VEGFC)通过与其配体(VEGFR3)的结合介导肿瘤淋巴管生成,是形成肿瘤淋巴道转移的最重要因素。淋巴道转移是非小细胞肺癌(NSCLC)常见的主要扩散途径。基于此,本研究用新的淋巴管内皮标志物podoplanin检测NSCLC组织中淋巴管,用淋巴管密度(LVD)表示淋巴管生成情况,探讨NSCLC内VEGFC表达与淋巴管生成和淋巴转移的关系。方法收集66例NSCLC和8例炎性假瘤组织标本,应用免疫组化检测VEGFC、podoplanin的表达,计算VEGFC阳性表达率及淋巴管密度值,分析两者的关系。结果NSCLC组织内VEGFC阳性表达率(75.8%)显著高于肺炎性假瘤(12.5%)(P<0.01),高中分化(76.3%)和低分化(75.0%)之间无显著性差异(P>0.05),淋巴结阳性组中VEGFC阳性率(86.5%)显著高于淋巴结阴性组(62.1%)(P<0.05)。NSCLC组织内LVD(20.4±5.9)显著高于肺炎性假瘤(10.9±4.9)(P<0.01);VEGFC阳性组LVD(21.3±6.0)显著高于VEGFC阴性组(17.7±5.1)(P<0.05),淋巴结阳性组LVD(21.9±5.9)显著高于淋巴结阴性组(18.5±5.5)(P<0.05)。结论淋巴管生成可能是NSCLC淋巴结转移的重要因素,VEGFC参与NSCLC淋巴管生成,从而促进淋巴结转移。     

VEGF、VEGF-C、Flt-4蛋白和MVD、LVD在乳腺癌组织中的表达及临床意义

目的探讨乳腺癌组织中VEGF、VEGF-C、Flt-4蛋白表达水平、MVD、Flt-4阳性脉管数及LVD六项指标之间的相互关系及其临床意义。方法采用免疫组织化学S-P法,检测105例乳腺癌石蜡标本中VEGF、VEGF-C、Flt-4、MVD、LVD及Flt-4阳性脉管数的表达水平。结果VEGF表达水平与MVD有显著相关性(P<0.01);VEGF-C表达水平与Flt-4表达水平有显著相关性(P<0.01),且二者均与Flt-4阳性脉管数及LVD有显著相关性(P<0.01)。在淋巴结转移组中,VEGF-C蛋白表达水平、Flt-4阳性脉管数及LVD均显著高于无淋巴结转移组(P<0.05)。在腋淋巴结阴性的血行转移患者中,VEGF及MVD的表达显著高于腋淋巴结阳性的血行转移患者(P<0.05),而VEGF-C、Flt-4及LVD的表达却显著低于后者(P<0.05)。MVD及VEGF-C的阳性表达与乳腺癌血行转移危险密切相关。结论VEGF促进微血管生成;VEGF-C、Flt-4促进淋巴管生成,且二者有显著相关性(P<0.01);VEGF-C、Flt-4及LVD与淋巴结转移状况密切相关;VEGF及MVD与腋淋巴结阴性患者血行转移相关;MVD及VEGF-C可能是乳腺癌患者发生血行转移的危险因素。     

VEGF-C和VEGF-D在胰腺癌淋巴转移中的意义

目的 分析胰腺癌肿瘤中心和肿瘤周边组织中血管内皮生长因子(VEGF)-C、VEGF-D与微血管密度(MVD)、微淋巴管密度(MLVD)的关系,探讨VEGF-C、VEGF-D在胰腺癌淋巴结转移及发展中的意义.方法 免疫组织化学法检测30例胰腺癌组织中VEGF-C、VEGF-D、VEGF受体(VEGFR)-3、CDM蛋白的表达情况.结果 30例胰腺癌中肿瘤周边部位VEGF-C、VEGF-D蛋白阳性率分别为73.3%和56.7%,显著高于肿瘤中心部位(30.0%和16.7%,P<0.01).VEGF-C、VEGF-D高表达的肿瘤周边部位淋巴结转移、淋巴管和血管浸润显著增加(P<0.01).VEGF-C蛋白阳性组MVD高于阴性组,MLVD显著高于阴性组(P<0.01),淋巴结转移增多;VEGF-D蛋白阳性组与阴性组相比MVD无变化(P=0.07),MLVD高于阴性组(P<0.01),淋巴结转移增加.结论 胰腺癌中肿瘤周边区域中VEGF-C、VEGF-D的表达与患者淋巴结转移显著相关,并介导其淋巴管生成;而VEGF-C可能主要参与胰腺癌的血管生成和淋巴管生成的调节,VEGF-D可能仅参与其淋巴管生成的调节.     

胃癌组织中血管内皮生长因子的表达对血管和淋巴管生成的影响及其预后意义

目的 研究胃痛组织中血管内皮生成因子(VEGF)-A、VEGF-C和VEGF-D的表达对血管和淋巴管生成的影响及其预后意义.方法 采用免疫组化法检测123例原发性胃癌组织中VEGF-A、VEGF-C和VEGF-D的表达,采用D2-40和CD34免疫组化双染法分别标记淋巴管和血管,并测定淋巴管密度(LVD)和血管密度(MVD).采用单因素分析VEGF-A、VEGF-C和VEGF-D表达与胃癌临床病理特征的关系;采用Kaplan-Meier法和Log rank检验评价VEGF-A、VEGF-C和VEGF-D表达与胃癌患者预后的关系,并用Cox比例风险模型进行多因素分析.结果 123例胃癌组织中,VEGF-A、VEGF-C和VEGF-D的高表达率分别为64.2%、65.9%和41.5%.VEGF-A、VEGF-C或VEGF-D高表达及两两高表达均与LVD有关(均P＜0.05);VEGF-A和VEGF-C高表达还与浸润深度、淋巴管浸润、静脉浸润、淋巴结转移和MVD有关(均P＜0.05);VEGF-C和VEGF-D高表达均与淋巴管浸润和淋巴结转移有关(均P＜0.05).VEGF-A、VEGF-C或VEGF-D高表达者的生存时间均明显短于其低表达者(均P＜0.05),其中VEGF-A和VEGF-C均高表达者的生存时间最短(56个月).VEGF-A的表达水平、MVD、淋巴结转移及浸润深度是影响胃癌患者预后的独立因素.结论 VEGF-A和VEGFC均高表达的胃癌有更强的促进血管和淋巴管生成的能力,并可促进肿瘤转移和影响患者预后;VEGF-C和VEGF-D可共同介导淋巴管生成,促进淋巴结转移;但仅VEGF-A高表达是影响患者预后的独立危险因素.     

COX-2的表达与甲状腺乳头状癌中淋巴管生成及淋巴结转移的关系

目的 探讨环氧化酶-2(COX-2)对甲状腺乳头状癌淋巴管生成的影响及与淋巴结转移的关系.方法 运用Envision免疫组化法测定60例甲状腺乳头状癌患者和15例癌旁正常甲状腺组织病理标本COX-2、血管内皮生长因子C(VEGF-C)的蛋白表达,并进行评分,同时用D2 40显色淋巴管进行淋巴管密度(LVD)计数.结果 甲状腺乳头状癌中COX-2、VEGF-C较正常组织表达明显增高;有淋巴结转移的甲状腺乳头状癌患者中COX-2、VEGF-C的阳性率明显高于无转移组(P<0.05;P<0.05);转移组LVD计数显著高于无转移组(P<0.01);COX-2与LVD(r=0.71;P<0.01)、VEGF-C与LVD(r=0.68;P<0.01)、COX-2与VEGF-C之间(r=0.65,P<0.01)存在显著正相关.结论 COX-2对甲状腺乳头状癌患者的淋巴管形成起着重要的作用,可能通过上调VEGF-C的表达促进肿瘤淋巴管的形成,有利于甲状腺乳头状癌淋巴结的转移.     

LYVE-1与血管内皮生长因子-C在喉鳞状细胞癌中的表达和意义

目的通过测定喉鳞状细胞癌组织内LYVE-1和血管内皮生长因子-C（VEGF-C）的表达情况,为喉鳞状细胞癌转移和预后的判定以及治疗提供一定的理论依据。方法通过免疫病理学方法检测LYVE-1的表达并计数喉鳞状细胞癌组织中淋巴管密度（LVD）,RT-PCR法检测喉鳞状细胞癌中VEGF-C的表达,使用统计学方法对LVD和VEGF-C表达进行分析。结果喉癌组织内存在LYVE-1（＋）的管腔样结构,LYVE-1在喉癌组织和癌旁正常组织之间表达差异有统计学意义（P〈0．05）,喉癌组织中VEGF-C mRNA的平均水平与正常组织之间差异有统计学意义（P〈0．05）,瘤组织比正常组织高4-5倍,而且喉癌组织内VEGF-C表达与LVD之间存在相关性。结论喉鳞状细胞癌瘤组织中存在淋巴管;VEGF-C mRNA在喉鳞状细胞癌组织中的表达要比正常对照组织高,且VEGF-C mRNA的高表达可能会通过促进瘤内淋巴管的增生来促进喉癌的淋巴结转移。     

Peritumoral lymphatic vessel density and vascular endothelial growth factor C expression in early-stage squamous cell carcinoma of the uterine cervix.

PURPOSE: Lymphatic invasion and nodal metastasis plays a major role in the spread of cervical cancer; however, little is known about the mechanisms whereby tumor cells enter the lymphatic system. EXPERIMENTAL DESIGN: We examined the intra- and peritumoral lymphatic vessel density (LVD) using D2-40 immunohistochemistry in 111 cervical squamous cell carcinomas and correlated them with vascular endothelial growth factor (VEGF)-C expression, clinicopathologic tumor features, and outcome. RESULTS: Compared with benign cervix, intratumoral and peritumoral LVD was significantly increased (P < 0.0001). Peritumoral LVD was significantly higher than intratumoral LVD (P = 0.009). High peritumoral, but not intratumoral, LVD showed significant correlation with high tumor stage, lymphatic invasion, and nodal metastasis. VEGF-C showed increased expression at the invasive edge compared with the center of tumors (P < 0.0001) and correlated with high peritumoral LVD, lymphatic invasion, and nodal metastasis. High peritumoral LVD and VEGF-C expression at the invasive edge of tumors were associated with poor overall and recurrence-free survival in univariate analysis. In multivariate analysis, peritumoral LVD was the only independent term predictive of overall survival. CONCLUSIONS: Our findings suggest a potential role for VEGF-C in tumor-induced lymphangiogenesis represented by high peritumoral LVD, which may be one of the mechanisms leading to lymphatic invasion and metastatic spread. High peritumoral LVD may be an independent prognostic factor in early-stage cervical cancer.     

Angiogenesis and Lymphangiogenesis in Salivary Gland Adenoid Cystic Carcinoma and Mucoepidermoid Carcinoma

Background and Purpose: This study aimed to investigate the immunohistochemical expression of CD31 and podoplanin in order to examine angiogenesis and lymphangiogenesis, respectively in common malignant tumors of salivary glands. Materials and Methods: Forty formalin-fixed, paraffinated blocks (20 adenoid cystic carcinoma and 20 mucoepidermoid carcinoma blocks) were selected from the medical archives of Amir A’lam Hospital of Tehran, Iran. Sections from the blocks were stained by CD31 and D2-40 markers via immunohistochemistry. Clinical and demographic information was extracted from the patients’ records. Findings: There was a significant difference between tumors in terms of intratumoral microvessel density (MVD) (P< 0.001), total MVD (P< 0.001), and intratumoral lymphatic vessel density (LVD) (P= 0.011). In mucoepidermoid carcinoma, intratumoral MVD and LVD were greater than peritumoral MVD and LVD (P= 0.001 and P< 0.001, respectively). In mucoepidermoid carcinoma, there was no relationship between histological grade with MVD (total, intratumoral or peritumoral) or LVD (total, intratumoral or peritumoral) (P> 0.05). A similar finding was reported with respect to the histopathological grade of adenoid cystic carcinoma (P> 0.05). Conclusion: The higher level of angiogenesis and lymphangiogenesis in mucoepidermoid carcinoma, specifically at the center of tumor, compared to adenoid cystic carcinoma, may be attributed to differences in the clinical behaviors and metastasis of tumors. Moreover, considering the high LVD at the center of tumor in mucoepidermoid carcinoma and infrequency of metastasis to regional lymph nodes in adenoid cystic carcinoma, it can play a significant role in metastasis to regional lymph nodes.     

胃癌淋巴管密度、微血管密度水平及其临床意义

目的 探讨胃癌组织中淋巴管密度（LVD）和微血管密度（MVD）水平及两者与胃癌临床病理特征的关系。方法 收集本院2004年2月至2007年2月手术切除的68例胃癌患者肿瘤组织,分别采用D2-40和CD31标记胃癌组织中淋巴管和血管,采用免疫组化法检测瘤周及瘤内D2 40、CD31表达情况并计算LVD和MVD,分析瘤周及瘤内LVD、MVD水平与临床病理参数（肿瘤大小、淋巴结转移、脏器转移、TNM分期、性别、年龄、分化程度、Lauren分型及病理类型）和预后的关系。结果 68例患者瘤内和瘤周LVD分别为（4.6±2.0）个和（8.2±3.5）个,瘤内和瘤周MVD分别为（46.3±16.5）个和（47.6±15.3）个;瘤周LVD与肿瘤大小、淋巴结转移、脏器转移及TNM分期有关（P＜0.05）,与性别、年龄、分化程度、Lauren分型及病理类型均无关（P＞0.05）;瘤内LVD、瘤内及瘤周MVD与以上参数均无关（P＞0.05）;全组中位总生存期（OS）为48.6个月,其中瘤周低LVD者的中位OS为31.0个月,低于瘤周高LVD的43.0个月（P＜0.05）;瘤周高MVD者的中位OS为46.0个月,而瘤周低MVD者为48.0个月,差异无统计学意义（P＞0.05）。结论 瘤周LVD与胃癌的临床病理特征及预后密切相关,可能成为胃癌发展及预后的预测指标。     

VEGF-A和VEGF-C在乳腺癌组织中的表达及其意义

背景与目的:VEGF家族都与血管生成相关,血管内皮生长因子-A(vascularendothelialgrowthfactorA,VEGF-A)和血管内皮生长因子-C(vascularendothelialgrowthfactorC,VEGF-C)与肿瘤的生长和转移关系密切。本研究探讨乳腺癌组织中VEGF-A、VEGF-C的表达与癌细胞增殖、微血管密度(microvesseldensity,MVD)和淋巴结转移的关系。方法:采用免疫组织化学方法观察98例乳腺癌组织中VEGF-A、VEGF-C、增殖细胞核抗原(proliferatingcellnuclearantigen,PCNA)、CD34的表达情况。结果:98例乳腺癌组织中,VEGF-A阳性率为85.7%(84/98),VEGF-C阳性率90.8%(89/98),两者在淋巴结转移组表达均高于未转移组,差异具有显著性(P<0.05)。PCNA的表达随着VEGF-A、VEGF-C表达强度增强,肿瘤细胞增殖活性也随之增强(r=0.432,P=0.000;r=0.294,P=0.001)。淋巴结转移组MVD值(64.26±26.40)明显高于未转移组(50.29±29.35)(P<0.05),且随着VEGF-A表达增强,MVD也随之增高(r=0.327,P<0.001),VEGF-C表达与MVD无相关性(r=0.123,P>0.05)。结论:VEGF-A主要介导了血管生成、细胞增殖和转移;VEGF-C促进乳腺癌细胞增殖,与血管密度无关,与淋巴结转移密切相关。     

淋巴管生成在直肠癌淋巴结转移中的作用及其对预后的影响

目的 观察直肠癌的淋巴管生成情况并探讨淋巴管生成在直肠癌淋巴结转移中的作用及对患者预后的影响.方法 以免疫组化方法对63例有完整随访资料的直肠癌及相应切缘正常组织的淋巴管进行染色,并测定淋巴管密度（lymphatic vessel density,LVD）;同时检测促淋巴管生长因子VEGF-C及其受体VEGFR-3的表达.结果 直肠癌肿瘤周边区淋巴管密度（peritumoral LVD,LVDpt）显著高于中心区淋巴管密度（intratumoral LVD,LVDit）及正常组织,而后两者相比差异无显著性;其中LVDpt与直肠癌VEGF-C及VEGFR-3的表达、淋巴结转移、低的5年生存率密切相关.结论 直肠癌主要是肿瘤周边区存在着淋巴管的生成,淋巴管的数量不但与直肠癌的淋巴结转移密切相关而且可以作为评价患者预后的一个可靠指标.     

VEGF-C及癌周淋巴管密度与头颈鳞癌颈部淋巴结转移的关系

目的探讨血管内皮细胞生长因子-C（VEGF-C）表达及癌周淋巴管密度（P-LVD）与头颈鳞癌（HNSCC）颈部淋巴结转移的关系。方法采用免疫组化法,检测104例HNSCC组织中VEGF-C及癌周LYVE-1的表达,幷计算P-LVD,分析P-LVD及VEGF-C表达与其临床病理因素的关系。结果 104例HNSCC组织中,VEGF-C阳性表达率显著高于正常头颈部黏膜组织（74.04%vs 0,P〈0.05）。淋巴结转移组VEGF-C阳性表达率高于无淋巴结转移组（P〈0.05）。对LYVE-1标记的淋巴管密度（LVD）分析显示,癌周组织P-LVD高于癌内及正常组织（P〈0.05）,而VEGF-C阳性表达者及颈部淋巴结转移者P-LVD分别显著高于VEGF-C阴性表达者和无颈部淋巴结转移者（P〈0.05）。结论 HNSCC中VEGF-C表达及P-LVD与肿瘤淋巴结转移密切相关,对判断肿瘤侵袭、转移具有一定参考价值。     

Vascular endothelial growth factor-A and -C: expression and correlations with lymphatic metastasis and prognosis in colorectal cancer

Previous studies obtained contradicting results regarding the correlation between expression of VEGF-A, VEGF-C and colorectal cancer patients’ clinicopathological features and prognosis. Moreover, the association between the growth factors’ expression and lymphatic vessel invasion (LVI) with intratumoral and peritumoral difference has not been reported. In this study, 81 primary colorectal cancer samples were immunohistochemically stained for VEGF-A, VEGF-C and podoplanin. The expression of VEGF-A and VEGF-C in marginal portion was significantly higher than those in central portion (P = 0.000 for both). The expression of VEGF-A in marginal portion was correlated with lymph node metastasis (P = 0.031). The expression of VEGF-C in marginal portion was correlated with TNM stage (P = 0.045), peritumoral LVI (P = 0.048) and lymph node metastasis (P = 0.019). The group with high VEGF-A expression in marginal portion showed worse survival than the low expression group (P = 0.039). Patients with high expression of VEGF-C in the marginal portion were not significantly different from those with low VEGF-C expression (P = 0.121). Patients with high expression of both VEGF-A and VEGF-C in the marginal portion showed the worst survival (P = 0.015). In conclusion, increased expression of VEGF-A and VEGF-C in marginal portion of colorectal cancer was correlated with lymph node metastasis. VEGF-C facilitates colorectal cancer cells invade into peritumoral lymphatic vessels, and different mechanisms may exist in the invasion of tumor cells into peritumoral and intratumoral lymphatic vessels. Assessment the expression of both VEGF-A and VEGF-C in the marginal portion of tumor may help to identify patients with colorectal cancer with unfavourable overall survival.     

Expressions of COX-2 and VEGF-C in gastric cancer: correlations with lymphangiogenesis and prognostic implications

Background

Cyclooxygenase-2 (COX-2) has recently been considered to promote lymphangiogenesis by up-regulating vascular endothelial growth factor-C (VEGF-C) in breast and lung cancer. However, the impact of COX-2 on lymphangiogenesis of gastric cancer remains unclear. This study aims to test the expression of COX-2 and VEGF-C in human gastric cancer, and to analyze the correlation with lymphatic vessel density (LVD), clinicopathologic features and survival prognosis.

Methods

Using immunohistochemistry, COX-2, VEGF-C and level of LVD were analyzed in 56 R0-resected primary gastric adenocarcinomas, while paracancerous normal mucosal tissues were also collected as control from 25 concurrent patients. The relationships among COX-2 and VEGF-C expression, LVD, and clinicopathologic parameters were analyzed. The correlations of COX-2, VEGF-C and level of LVD with patient prognosis were also evaluated by univariate tests and multivariate Cox regression.

Results

The expression rates of COX-2 and VEGF-C were 69.64% and 55.36%, respectively, in gastric carcinoma. Peritumoral LVD was significantly higher than that in both normal and intratumoral tissue (P < 0.05). It was significantly correlated with lymph node metastasis and invasion depth (P = 0.003, P = 0.05). VEGF-C was significantly associated with peritumoral LVD (r = 0.308, P = 0.021). However, COX-2 was not correlated with VEGF-C (r = 0.110, P = 0.419) or LVD (r = 0.042, P = 0.758). Univariate analysis showed that survival time was impaired by higher COX-2 expression and higher peritumoral LVD. Multivariate survival analysis showed that age, COX-2 expression and peritumoral LVD were independent prognostic factors.

Conclusions

Although COX-2 expression was associated with survival time, it was not correlated with VEGF-C and peritumoral LVD. Our data did not show that overexpression of COX-2 promotes tumor lymphangiogenesis through an up-regulation of VEGF-C expression in gastric carcinoma. Age, COX-2 and peritumoral LVD were independent prognostic factors for human gastric carcinoma.     

胃癌组织COX-2、VEGF-C表达与淋巴结转移及预后关系的研究

目的:探讨环氧化酶-2(cyclooxygenase-2,COX-2)、血管内皮生长因子C(VEGF-C)在胃癌组织中的表达及其与淋巴管生成、淋巴结转移及预后的关系.方法:采用免疫组织化学SABC法检测 51例胃癌及相应的癌旁组织COX-2、VEGF-C及受体VEGFR-3表达,计数肿瘤内淋巴管密度(LVD),并结合临床病理特征和随访资料进行分析.结果:胃癌组织COX-2、VEGF-C表达阳性率分别为62.8%(32/51),60.7%(31/51).COX-2表达与VEGF-C(r=O.74,P＜0.05)、临床分期(r=0.34,P＜0.05)、淋巴管密度(r=0.69,P＜0.01)和淋巴结转移(r=0.57,P＜0.01)呈正相关,与病理分化呈负相关(r=-0.58,P＜0.01).VEGF-C表达与淋巴管密度(r=0.45,P＜0.01)、淋巴结转移呈正相关(r=0.46,P＜0.05).随访5年,胃癌组织COX-2表达与生存率呈负相关,COX-2表达阴性组5年生存率(36.8%)显著高于COX-2表达阳性组(15.6%)(P＜0.05).结论:在胃癌组织中,COX-2、VEGF-C高表达,COX-2与VEGF-C、淋巴管密度、淋巴结转移呈正相关.推测COX-2通过诱导VEGF-C表达参与淋巴结转移.胃癌组织COX-2检测可能对推测预后具有重要意义.