VEGF in 105 pheochromocytomas: enhanced expression correlates with malignant outcome

Pheochromocytomas are rare sympathoadrenal tumors that are highly vascular. Their malignancy is extremely difficult to estimate on the basis of histopathological features. Vascular endothelial growth factor (VEGF) is one of the most important angiogenic factors involved in both tumor growth and metastasis. In our search for new prognostic markers, we investigated the expression of VEGF in normal adrenal gland, in 105 primary pheochromocytomas, and in 6 metastases by using immunohistochemistry and Northern blot analysis. We also calculated the microvessel density of these tumors by staining the endothelial cells with monoclonal CD34 antibody. VEGF messenger ribonucleic acid was found in all pheochromocytomas studied. Immunohistochemically, VEGF was not found in normal adrenal medullary cells. Interestingly, all malignant pheochromocytomas (n=8), regardless of their primary location, had strong or moderate VEGF immunoreactivity, while most benign adrenal pheochromocytomas (26 of 37, 70.3%) were either negative or only weakly positive. The staining was heterogenous in extraadrenal pheochromocytomas as well as in a group of tumors that had histologically suspicious features but had not metastasized, here called borderline tumors (n=29). The microvessel density varied greatly in all of the tumor groups, and no statistical difference was found between these groups. Here we report moderate to strong VEGF expression in malignant pheochromocytomas, and negative or weak expression in benign adrenal pheochromocytomas. Normal medullary cells are immunohistochemically negative. Thus, low VEGF expression in pheochromocytomas favors a benign diagnosis.     

乳腺癌中CD105表达及相关因素分析

目的 多项免疫组化（multiple immunohistoehemistry,MIHC）检测内皮因子CD105作为判断患者乳腺癌生物学行为及预后指标的可能性。方法 选取2003年11月-2004年1月经河北医科大学病理科确诊为原发性乳腺癌患者石蜡包埋组织标本87例,癌旁组织标本20例,同期乳腺良性病变标本24例。以CD105单克隆抗体为标记物进行免疫组化染色,根据CD105的表达水平计测微血管密度（mierovessel density,MVD）。结果CD105所标记的MVD在乳腺癌组织和乳腺良性病变以及乳腺良性病变与癌旁组织之间的表达差异均有显著性（P＜0．05）,癌旁组织中CD105几乎表达缺失;淋巴结转移阳性、组织分化差（Ⅲ级）、临床TNM分期晚以及VEGF表达阳性、ER、PR表达阴性的患者中,CD105的表达明显升高,差异均有显著性（P＜0．05）。结论 CD105主要在处于增殖状态的血管内皮细胞上表达,在标记肿瘤组织活性微血管方面特异性极高,是检测乳腺癌患者预后的重要指标。     

Camel milk inhibits inflammatory angiogenesis via downregulation of proangiogenic and proinflammatory cytokines in mice

Camel milk has traditionally been used to treat cancer, but this practice awaits scientific scrutiny, in particular its role in tumor angiogenesis, the key step involved in tumor growth and metastasis. We aimed to investigate the effects of camel milk on key components of inflammatory angiogenesis in sponge implant angiogenesis model. Polyester‐polyurethane sponges, used as a framework for fibrovascular tissue growth, were implanted in Swiss albino mice and camel milk (25, 50 and 100 mg/kg/day) was administered for 14 days through installed cannula. The implants collected at day 14 post‐implantation were processed for the assessment of hemoglobin (Hb), myeloperoxidase (MPO), N‐acetylglucosaminidase (NAG), and collagen, which were used as indices for angiogenesis, neutrophil, and macrophage accumulation and extracellular matrix deposition, respectively. Relevant inflammatory, angiogenic, and fibrogenic cytokines were also determined. Camel milk treatment attenuated the main components of the fibrovascular tissue, wet weight, vascularization (Hb content), macrophage recruitment (NAG activity), collagen deposition and the levels of vascular endothelial growth factor (VEGF), interleukin (IL)‐1β, IL‐6, IL‐17, tumor necrosis factor‐α, and transforming growth factor‐β. A regulatory function of camel milk on multiple parameters of the main components of inflammatory angiogenesis has been revealed, giving insight into the potential therapeutic benefit underlying the anti‐cancer actions of camel milk.     

抗CD34单抗标记血管生成在非小细胞肺癌中的表达及临床意义

目的探讨非小细胞肺癌中 CD34标记的血管生成的表达及临床意义。方法采用免疫组化法检测 81例手术切除的非小细胞肺癌标本中抗内皮细胞表面抗原 CD34单抗标记的血管生成。结果 CD34以其染色的特异性、敏感性及清晰的背景而易于识别。统计学分析显示微血管密度同肺癌临床分期的进展及血行转移密切相关 ,但未发现同淋巴结转移及其它临床病理特征有关。结论肺癌中微血管密度对血行转移的进展有重要作用且同肺癌的发生有关。     

Morphology of angiogenesis in human cancer: a conceptual overview, histoprognostic perspective and significance of neoangiogenesis

This paper reviews the histomorphological aspects of angiogenesis and neoangiogenesis, quantitative and qualitative, and their applications in prognostic evaluation of neoplastic diseases. The merits and weak points of intratumoral microvessel density (MVD), a widely regarded bona fide predictor of tumour growth, metastases and patient survival, are discussed. Total microvascular area (TVA) has been found useful in recent prognostic studies utilizing newer immunohistochemical vascular markers. Of particular significance is the fact that MVD and TVA are most predictive of patient outcome in those tumours that induce significant neoangiogenesis, namely carcinomas of breast and prostate, and haematological malignancies. In contrast, carcinomas of lung and urinary bladder do not show significant associations of MVD and TVA with poor prognosis, reflecting differences in angiogenic mechanisms. In gliomas, MVD appears to correlate with outcome in high-grade, but not low-grade tumours, and does not correlate with tumour cellularity in the infiltrating portions of the tumour, reflecting a paucity of neoangiogenesis and directional vascular growth. Recent studies have found CD105, Tie-2/Tek and vascular endothelial growth factor receptors to be the best markers of neoangiogenesis. The vascular parameters so measured correlate better with overall and disease-free survival in breast, colon and lung carcinoma than panendothelial markers such as CD31. A correlation of vascular patterns with prognosis has been established in ocular melanomas, glioblastomas and squamous carcinomas of head and neck region. Vascular networks with closed loops are closely associated with mortality due to metastases in uveal melanomas. Fewer bizarre glomeruloid vessels and prominent classical capillary pattern was an independent predictor of longer survival in glioblastoma. Therefore a judicious combination of quantitative and qualitative microscopic angiogenic parameters, with emphasis on neoangiogenesis and vascular patterns wherever applicable, should be an integral component of a more consistent tumour staging system for accurate prognostic evaluation of tumours, selection of optimal anti-angiogenic therapy and pertinent research.     

胃癌组织中CXCR3表达与微血管形成的关系及其临床意义

目的探讨胃癌组织中CXCR3的表达和微血管形成的关系并分析其临床意义。方法采用免疫组化法检测169例胃癌组织中CXCR3蛋白表达和肿瘤间质微血管密度(microvascular density,MVD),分析其相关性及其与胃癌临床病理参数的关系。结果 CXCR3表达在分化程度高(P=0.025)、浸润程度浅(P=0.005)、TNM分期低(P=0.002)及无淋巴结转移(P=0.001)的胃癌患者中更高;MVD在胃癌分化程度低者中更高(P=0.001),与浸润深度、TNM分期及淋巴结转移无关(P0.05)。胃癌组织中CXCR3表达与MVD呈负相关(r=-0.151,P=0.049)。Kaplan-Meier分析发现高表达CXCR3的胃癌患者(P=0.015)和低MVD患者(P=0.047)的生存时间延长。结论胃癌中CXCR3的表达与MVD呈负相关,且与胃癌的浸润、转移相关。     

Increased microvessel density in malignant and borderline mammary phyllodes tumours

AIMS: Tumour vascularity is considered a prognostic indicator in breast carcinoma, but its utility in mammary phyllodes tumour has not been explored. The authors report the correlation between intratumoral microvessel density and the histological grade of phyllodes tumour. METHODS AND RESULTS: Forty cases of phyllodes tumour were reviewed for stromal cellularity, overgrowth, cytological pleomorphism, mitotic count and margin pattern. Using established criteria, these were diagnosed as benign (n=28), borderline (n=10) and malignant (n=2). Microvessel density was counted on CD31-stained slides as the number of vessels per high power field. For benign phyllodes tumour, the range was 7-26.2 (mean 13.1); for borderline phyllodes tumour the range was 17.2-32.5 (mean 22.4); for malignant phyllodes tumour the range was 25.9-33.3 (mean 29.6). The difference between the benign and borderline groups was significant (P < 0.0001) but that between the borderline and malignant groups was not, due to the small number of malignant cases. CONCLUSIONS: There is a significant difference in stromal microvessel density between benign and borderline phyllodes tumour. Although the small number of cases of malignant phyllodes tumour limits further interpretation, we believe that microvessel density can be used as an additional objective histological parameter in the evaluation of phyllodes tumour.     

碱性成纤维细胞生长因子与卵巢癌的关系

目的　探讨碱性成纤维细胞生长因子 (basic fibroblast growth factor,b FGF)对卵巢癌细胞增殖、浸润和肿瘤血管生成的影响 ,及 b FGF单克隆抗体 (b FGF monoclonal antibody,b FGF- MAb)的治疗作用。　方法　将人卵巢癌细胞株 SKOV3接种于 2 4孔板 ,加入不同浓度的 b FGF,每日行结晶紫染色后测定光密度 (D4 90 )值 ,绘制细胞生长曲线 ;将 SKOV3细胞团接种于铺设有细胞外基质凝胶的 4孔板 ,每日测定癌细胞在凝胶中的浸润距离 ;建立 SKOV3细胞裸鼠皮下移植瘤模型 ,每周两次分别将 b FGF、b FGF-MAb和生理盐水注射于移植瘤周围 ,8周后测量肿瘤体积 ;对移植瘤组织切片行 因子的免疫组化染色、测定肿瘤内微血管密度 (microvessel density,MVD)。　结果　 b FGF能促进 SKOV3细胞增殖并呈浓度依赖 ,实验第 5天 ,5 ng/ml、10 ng/ml组细胞 D4 90 值是对照组的 1.0 9倍和 1.2 1倍 ;b FGF能促进 SKOV3细胞浸润并呈浓度依赖 (P<0 .0 5 ) ,第 7天 ,5 ng/ml、10 ng/ml组细胞浸润距离分别是对照组的 1.5 3倍和2 .4 5倍 ;b FGF组移植瘤体积和 MVD分别是对照组的 1.80倍和 1.4 6倍 (P<0 .0 5 ) ,b FGF- MAb组移植瘤体积和 MVD分别是对照组的 6 3.7%和 6 2 .8% (P<0 .0 5 )。　结论　b FGF能明显促进卵巢癌细胞的增殖、     

Intratumoral microvascular density in malignant lymphomas of B-cell origin

Sections of surgical lymph-node biopsies of four types of malignant non-Hodgkin's lymphoma of B-cell origin (B-NHL) classified according to the R.E.A.L. terminology or lymphadenitis were immunostained in order to demonstrate endothelial CD34 (QBEnd 10) and to determine the microvascular density and vessel-size distribution using an interactive image-analysis technique. Only microvessels displaying a cross-sectional area corresponding to a diameter of between 3.2 and 34.6 microm were included. The intratumoral microvascular density (iMVD) was found to be significantly higher in chronic lymphatic leukaemia (CLL, n = 13) compared with the clinically more aggressive mantle cell lymphoma (MCL, n = 9) and diffuse large B-cell lymphoma (DLBCL, n = 14). iMVD in CLL was also higher than in the follicular neoplastic parts (FL FOLL) of follicular lymphoma (FL, n = 16). In FL FOLL the microvessel density was, moreover, significantly lower than in the surrounding non-neoplastic FL tissue. In lymphadenitis (LA, n = 10) the iMVD was higher than in DLBCL, FL FOLL and MCL. The data suggest that future studies focusing on the relationship between iMVD and the clinical outcome within each particular NHL group should be carried out in order to verify whether iMVD is a prognostic factor in NHL, as it is in carcinomas.     

Tumour-type-specific capillary endothelial cell stainability in malignant B-cell lymphomas using antibodies against CD31, CD34 and Factor VIII

The microvessel density (MVD) was assessed in lymph nodes infiltrated by diffuse large B-cell lymphomas, mantle cell lymphomas, chronic lymphatic leukemia and follicular lymphomas, and in lymphadenitis. Serial sections of formalin-fixed and paraffin-embedded tissue were stained with antibodies against CD31, CD34 or Factor VIII. Using light microscopy and computerised image analysis, the number and size of individual immunostained vessel profiles within a preselected area size range corresponding to capillaries, postcapillary venules, small collecting venules and small arterioles were determined. A significantly larger number of vessels were registered following staining with anti-CD34 than with anti-CD31 or anti-Factor VIII. Moreover, among the smallest capillary-sized vessel profiles in all lesion types, there was a selective relative loss of stainability of anti-CD31 and anti-Factor VIII, resulting in a substantial total loss of visualised capillary-sized vessels compared with anti-CD34. In fact, the number of non-detected capillaries following staining with anti-CD31 and anti-Factor VIII was significantly tumour type specific. These findings influence how we evaluate MVD data in B-cell lymphomas and possibly also other tumour types, as well as data relating to capillary endothelium-related functional variables of proliferation, apoptosis and maturation when different double-labelling immunohistochemical techniques are used and different tumour types are analysed.     

非霍奇金淋巴瘤中的微血管密度及其临床病理意义

目的：探讨非霍奇金淋巴瘤(NHL)中的微血管密度(MVD)及其与NHL恶性程度、免疫学类型、预后的关系；方法：采用生物素标记的荆豆凝集素I(Bio-UEA-I)免疫组化ABC法对102例NHL的MVD进行原位观察和数量分析；结果：MVD随NHL恶性程度的增高而增高，高度恶性组和中度恶性组MVD显著高于低度恶性组MVD；T细胞性NHL中的MVD显著高于B细胞性NHL的MVD；短生存期组的MVD显著高于长生存期组的MVD；结论：NHL中的MVD可作为判断肿瘤恶性程度、免疫学类型及预后估计的有意义的指标，在临床病理中有实际应用价值。     

胸苷磷酸化酶在结直肠癌中的表达及与血管生成的关系

目的：研究结直肠癌组织中胸苷磷酸化酶（thymidine phosphorylase,TP)表达与癌组织分化程度，淋巴结转移及肿瘤内微血管密度（MVD）的关系。方法：对50例结直肠癌标本及21例正常结直肠黏膜组织进行免疫组化S－P法测定癌组织中TP的表达情况；通过CD34免疫组化染色检测癌组织中的MVD。结果：结直肠癌细胞的TP表达阳性率高于正常结直肠黏膜上皮（P＜0．01）；TP阳性组中局部淋巴结转移率高TP阴性组；TP阳性组的MVD高于TP阴性组；它们的差别均具有统计学意义，结直肠癌中高、中、低分化癌组之间的TP阳性率无明显差异。结论：癌细胞中TP的表达与肿瘤的血管生成及淋巴结转移有关。但与结直肠癌的组织化学级别无关。     

胃癌中肿瘤微环境转移的价值

目的研究胃癌中是否存在肿瘤微环境转移(tumor microenvironment of metastasis,TMEM)及其与胃癌血道转移的相关性。方法采用免疫组化双染法同时标记巨噬细胞和内皮细胞,计数26例远处转移及其配对26例无远处转移胃癌组织中TMEM密度。结果 (1)TMEM存在于胃癌组织中;(2)TMEM与分化程度、临床分期明显相关(P<0.001,P=0.006),与肿瘤大小、Lauren分型、淋巴结转移等其他临床病理特点无关(P均>0.05);(3)TMEM与有无远处转移呈正相关(P<0.001)。结论证实胃癌中存在TMEM,TMEM密度可以预测胃癌血道转移,有望成为评估胃癌血道转移危险性的新预测指标。     

Endoglin (CD105) expression and angiogenesis status in small cell lung cancer

It is well established that angiogenesis is crucial for tumor development and progression. Among the angiogenesis immunomarkers defined to date, endoglin (CD105) has been shown to be a useful marker of angiogenesis. To investigate the degree of angiogenesis status in small cell lung cancer (SCLC) tissue, we assessed 35 cases of SCLC at autopsy using immunohistochemical staining of CD31 and CD105. The intratumoral area, peritumoral area, and background pulmonary alveoli were then observed under low magnification, and the microvessel density (MVD) for each area was determined. The MVD-CD31 was the highest in the background alveoli, followed by the intratumoral and peritumoral areas. The MVD-CD105 was highest in the intratumoral area, followed by the peritumoral area and the background lung. The ratio of CD105/CD31 revealed that almost 78% of the intratumoral area, 63% of the peritumoral area, and 4.6% of the background lung alveoli were newly formed and expressed CD105. This result indicated that SCLC is predominantly supported by newly formed vessels that are generated by CD105-mediated angiogenesis. These findings suggest that anti-angiogenic therapy, especially CD105-targeting, may prove an effective form of SCLC treatment.     

功率多普勒成像与MVD、VEGF检测乳腺肿块血管生成的相关性研究

目的探讨功率多普勒成像（PDI）与微血管密度（MVD）、血管内皮生长因子（VEGF）检测乳腺肿块血管形成的相关性并评价其临床应用价值。方法选择2005年9月～2006年3月山西医科大学第二医院乳腺科乳腺肿块患者39例．均为女性．年龄22～71岁,平均年龄44．5岁（良性组39．2岁,恶性组48．8岁）。良性17例,恶性22例。对全部患者行超声检测,采用计算机Photoshop 7．0软件对肿块功率多普勒血流信号进行定量分析．测定彩色像素密度（CPD）;用抗CD34因子及抗VEGF因子免疫组织化学染色测定肿块MVD及VEGF阳性表达率．对CPD与MVD的相关性进行分析。结果恶性组CPD、MVD及VEGF阳性表达率较良性组高．两者差异有显著统计学意义（P〈0．01）,CPD与MVD间具有良好相关性（r=0．822．P〈0．01）。结论PDI所测CPD可较好反映乳腺肿块血流情况,有助于乳腺疾病的鉴别诊断,与MVD计数、VEGF测定相结合,能全面反映肿瘤血管生成状态。     

食管鳞状细胞癌中HGF表达与肿瘤血管形成的关系

目的研究肝细胞生长因子(hepatocyte growth factor,HGF)在食管鳞癌中的表达及其与肿瘤血管形成之间的关系。方法应用免疫组化PV两步法检测64例食管鳞癌组织及20例癌旁正常组织中HGF及CD34的表达情况,并计数微血管密度(microvessel density,MVD)。结果 HGF在食管鳞癌中的表达(76.6%)高于癌旁正常组织(15.0%,P<0.05),且与肿瘤直径、分化程度及淋巴结转移有关;食管鳞癌组织的MVD值(38.87±17.55)/mm2明显高于癌旁正常组织的MVD值(15.10±3.76)/mm2(P<0.05),肿瘤直径>5 cm,有淋巴结转移及侵袭较深的肿瘤MVD值高(P<0.05);食管鳞癌中HGF阳性组MVD值为(42.25±16.50)/mm2,高于HGF阴性组MVD值(27.89±16.83)/mm2(P=0.005),且MVD值与HGF的表达之间具有相关性。结论 HGF的高表达与食管鳞癌的恶性生物学行为及肿瘤血管生成关系密切,HGF可作为食管鳞癌生物治疗的潜在靶点。     

Microvascular structural entropy: A novel approach to assess angiogenesis in pituitary tumors

Entropy, a measure of the degree of disorder in a system, has recently been used in different morphologic studies to quantify regularity. Our aims were (a) to study the structural organization of the microvascular bed in prolactin (PRL)-producing adenomas and carcinomas, the most vascularized of pituitary tumors, by assessing microvascular structural entropy (MSE), and (b) to determine whether the degree of disorder of the capillary bed correlates with tumor cell proliferation as estimated by MIB-1 labeling, microvessel density (MVD), the most widely used method of quantifying blood vessel formation, and various clinicopathologic parameters (gender, age, tumor size and invasiveness). The morphometric study demonstrated statistically significant differences in MIB-1 labeling, MVD, and MSE between PRL-producing adenomas and carcinomas. Unlike MIB-1 labeling index (PRL-producing adenomas 1.5±0.27; carcinomas 15.0±4.04) and MVD (PRL-producing adenomas 2.7±0.34; carcinomas 4.2±0.72), the MSE values were significantly higher in adenomas (171.5±25.37) than in carcinomas (67.9±17.45). These results indicate that PRL-producing carcinomas have a less chaotic distribution of vessels than benign adenomas. In contrast to a lack of correlation between, microvessel density and other morphometric parameters, a strong negative correlation was found between MSE and MIB-1 labeling index (r=0.511, p=0.003). It thus appears that regular, less chaotic microvascular geometry contributes to increased proliferative activity in PRL cell tumors. Analysis of MSE may provide an independent parameter of tumor behavior, and contributes to a better understanding of the role of microvasculature in pituitary tumor progression.     

人静脉移植物中MCP-1的表达

目的：探讨人静脉移植物中单核细胞趋化蛋白-1（MCP-1）的表达及其与巨噬细胞浸润的关系。方法：应用免疫荧光组织化学技术对30个静脉移植物再塞标本中MCP-1、CD68（巨噬细胞的标记物）、CD3l（内皮细胞的标记物）的表达进行了检测，用激光共聚焦显微镜拍片，图片用Silicon Graphics Octane进行处理。结果：在正常静脉血管中，MCP-1表达很弱；外膜中有少量CD68免疫阳性细胞，中膜和内膜中少见；CD31免疫阳性细胞仅在血管腔内皮细胞和外膜小血管中可见。在病变静脉血管，MCP-1在内皮细胞、平滑肌细胞中的表达呈强阳性；CD68免疫阳性细胞在外膜、中膜和内膜均可见到；CD31免疫阳性细胞不仅出现在血管腔内皮细胞和外膜小血管内皮细胞，且在中膜小血管内皮细胞也大量出现。免疫双重染色显示内皮细胞和巨噬细胞均表达MCP-1。结论：人静脉移植物MCP-1的表达上调，且和巨噬细胞的浸润关系密切，提示MCP-l对静物移植物炎症细胞的浸润及新内膜的形成有非常重要的作用。     

胶质瘤中hTFERT、VEGF表达及其与肿瘤血管形成的关系

目的 探讨胶质瘤中端粒酶逆转录酶(hTERT)、血管内皮生长因子(VEGF)的表达与肿瘤血管形成问的相互关系.方法 分别用原位杂交和免疫组化染色检测106例胶质瘤hTERT和VEGF的表达;用CD34标记瘤组织血管内皮细胞,测定微血管密度(MVD).结果 hTERT、VEGF总阳性表达率分别为53.8%(57/106)、68.0%(72/106);hTERT或VEGF阳性分别定位于肿瘤细胞核内和细胞质内.hTERT阳性或VEGF阳性的瘤组织MVD分别为71.2±18.0和74.4±20.0;而相应的阴性组分别为60.3±21.8和58.4±23.1,两组差异均有显著性(P＜0.01).hTERT、VEGF的表达和MVD均与胶质瘤组织病理分级呈正相关(P＜0.01).结论 hTERT、VEGF的表达及MVD均与胶质瘤的恶性程度有关,前两者阳性表达,其MVD高于两者阴性表达,说明hTERT、VEGF在肿瘤血管形成中可能起促进作用.