VEGF-C表达和微淋巴管密度与胃癌淋巴转移的关系及意义

目的探讨胃癌组织血管内皮生长因子C(VEGF-C)表达和微淋巴管密度(MLVD)及两者与胃癌淋巴转移的关系。方法应用免疫组织化学方法检测208例人胃癌组织、40例癌浸润前缘组织及139例人胃正常粘膜组织中VEGF-C、D2-40的表达,对D2-40阳性脉管进行MLVD计数,并结合病理资料进行统计学分析。结果胃癌组织VEGF-C的表达明显高于正常胃粘膜组织(χ2=109.199,P<0.01);胃癌组织中有淋巴结转移(χ2=14.496,P<0.01)或浸润透浆膜(χ2=11.586,P<0.01)组VEGF-C表达水平分别较无转移或浸润未及浆膜组增高。癌浸润前缘组织中MLVD(18.36±15.60个/mm2)明显高于胃癌组(9.41±9.32个/mm2,t=-3.681,P<0.01)和胃正常粘膜组织(7.70±7.69个/mm2,t=-4.180,P<0.01);胃癌淋巴结转移组MLVD(9.81±9.97个/mm2)高于无转移组(6.41±7.85个/mm2,t=2.516,P<0.01),而在浸润透浆膜组(11.20±10.55个/mm2)和未及浆膜组(8.54±9.36个/mm2)MLVD无差别(t=1.467,P=0.472)。另外,在胃癌组织中VEGF-C表达与MLVD呈正相关(F=2.910,P<0.05)。结论VEGF-C在胃癌中的高表达与胃癌浸润深度、淋巴转移密切相关。     

胃癌组织中COX-2表达及其与微血管和微淋巴管密度的关系

目的 研究胃癌组织中COX-2表达的临床病理学意义,同时探讨COX-2与微血管密度(MVD)和微淋巴管密度(MLD)的关系.方法 采用免疫组化EnVision两步法,检测46例胃癌中COX-2的表达,同时标记CD34和D2-40,分别检测胃癌组织中微血管和微淋巴管密度.结果 46例胃癌中COX-2表达的阳性率为80.43%(37/46),COX-2的表达与患者性别、浸润深度无关(P>0.05),而与肿瘤大小、组织学分期、淋巴结转移和临床分期等临床病理参数密切相关(P<0.05);COX-2表达阳性组的平均生存时间明显低于表达阴性组(P<0.05);COX-2表达阳性组的MVD和MLD明显高于COX-2表达阴性组(P<0.05).结论COX-2可能通过促进肿瘤的血管和淋巴管形成而参与了胃癌细胞的浸润转移,导致胃癌患者预后不良.     

Prox-1与淋巴管新生和肿瘤转移的关系

侵袭和转移是恶性肿瘤的重要生物学行为之一,淋巴道转移是恶性肿瘤难以根治以及高病死率的主要原因,也是判断患者预后的主要指标。果蝇prospero同源异形盒蛋白1（prospero homeobox protein 1,Prox-1）在胚胎时期淋巴管形成过程中具有重要作用,可以作为淋巴管内皮细胞标志物,显示肿瘤新生淋巴管,并与肿瘤淋巴道转移密切相关。尽管Prox-1促进胚胎淋巴管形成机制的研究较为深入,但是在肿瘤淋巴管新生和淋巴道转移的作用机制方面仍有待于进一步探讨,Prox-1可能作为抑制肿瘤淋巴管新生和治疗肿瘤的新靶点,用于阻断肿瘤转移和改善患者预后。现就Prox-1与胚胎淋巴管形成、肿瘤淋巴管新生以及与肿瘤淋巴道转移关系的相关研究现状综述如下。     

胃癌淋巴管E钙黏蛋白、β连环素的表达与癌转移的关系

目的:探讨胃癌淋巴管E钙黏蛋白、β连环素的表达与癌转移的相关性。方法:胃癌标本32例,正常胃组织标本2例。通过免疫组织化学方法,用淋巴管内皮透明质酸受体-1(LYVE-1)标记定位,观察胃癌淋巴管E钙黏蛋白和β连环素的表达。结果:LYVE-1在淋巴管阳性表达,正常组织淋巴管E钙黏蛋白、β连环素表达阴性。胃癌组织淋巴管的E钙黏蛋白表达阴性。β连环素在淋巴管的表达,低分化组表达率为56.5%,与高分化癌淋巴管的表达率(43.3%)有明显差异;有淋巴结转移组表达率58.5%,和无转移癌表达率(43.3%)也有明显差异。结论:E钙黏蛋白/β连环素复合物在介导肿瘤细胞进入淋巴管中起一定的作用,β连环素弱阳性表达与癌的转移有正相关性。     

微淋巴管和微血管密度对结直肠癌的预后意义

目的观察微淋巴管密度（MLD）和微血管密度（MVD）在结直肠癌中的分布特点,探讨其转移与预后意义。方法利用淋巴管和血管特异标记物Podoplanin和CD34行免疫组化EnVision法检测227例结直肠癌及正常黏膜,观察MLD、MVD分布特点,分析其与临床病理参数之间的关系。结果结直肠癌前缘区MLD（19．64±7．21）高于肿瘤中央区MLD（5．64±2．87）和正常黏膜MLD（13．30±3．06）;肿瘤前缘区MVD（40．93±11．71）亦高于肿瘤中央区MVD（21．07±8．38）和癌旁正常黏膜（29．32±11．69）,差异有统计学意义（P〈0．05）。结直肠癌前缘区MLD与肿瘤浸润深度、淋巴管侵犯、淋巴结转移及远处器官转移等临床病理参数相关,差异有统计学意义（P〈0．05）。肿瘤前缘区MLD、MVD增高与结直肠癌的不良预后密切相关（P〈0．05）,但不是独立预后因素。结论结直肠癌微淋巴管和微血管分布以肿瘤前缘区最为密集,且前缘区MLD和MVD增高是评估结直肠癌预后不良的指标。     

淋巴管内皮细胞透明质酸受体-1在发育小鼠肾内的表达

目的:探讨淋巴管内皮细胞透明质酸受体-1(LYVE-1)在发育小鼠肾内的表达.方法:胚胎期第13～18天(E13～18)的胎鼠和出生后第4、 14和21天(P4～21)及成年小鼠的肾,行LYVE-1免疫组织化学显色.结果:LYVE-1免疫阳性淋巴管丛最早在胚胎期第14天的小鼠肾检测到,主要位于肾皮质的动脉周围.在胚胎期第15天的肾小球中最早检测到LYVE-1免疫阳性细胞,但LYVE-1免疫阳性细胞在肾小球中的数量和位置不定.结论:LYVE-1免疫阳性细胞主要位于肾动脉周围淋巴管,在肾小球中也有LYVE-1表达.     

肿瘤淋巴管与肿瘤转移的研究进展

肿瘤细胞浸润淋巴管并发生淋巴结转移是导致肿瘤患者死亡的主要原因。研究表明,肿瘤中存在结构和分布异常的淋巴管,其生成与肿瘤细胞产生的细胞因子（如VEGF-C、Cox-2）有关。目前,随着特异性的淋巴内皮的标记物VEG—FR-3、LYVE-1、podoplanin、D2-40等的发现,肿瘤淋巴管已成为当前研究热点。笔者就近来有关肿瘤淋巴管和肿瘤转移的研究进展综述如下。[第一段]     

三阴乳腺癌组织表皮生长因子受体表达及其与微血管密度和微淋巴管密度的相关性

目的:检测表皮生长因子受体(EGFR)在三阴乳腺癌(TNBC)患者癌组织中的表达及与癌组织中微血管密度(MVD)和微淋巴管密度(MLVD的相关性。方法:应用免疫组化法检测48例TNBC癌组织EGFR表达及MVD和MLVD,分析EGFR的表达程度与MVD和MLVD的相关性。结果:TNBC患者癌组织中的EGFR阳性表达率为66.67%(32/48),其中(+)和(++)者各4例(8.33%),(+++)者9例(18.75%),(++++)者15例(31.25%),EGFR阳性表达与其MVD和MLVD呈显著正相关(P0.01)。结论:TNBC癌组织高表达EGFR及高MVD和高MLVD,从而影响肿瘤生物学行为及患者预后;抗EGFR靶向治疗可能使患者获益。     

肿瘤转移相关蛋白1的表达与人直肠癌组织淋巴管转移及预后关系

目的观察肿瘤转移相关蛋白1(MTA1)与直肠癌淋巴结转移及预后的关系,探讨MTA1在直肠癌发生发展过程中的作用。方法应用免疫组化法和实时荧光定量PCR方法检测MTA1在45例人直肠癌和20例直肠息肉组织中的表达,并结合临床病理特征和生存资料进行相关分析。结果直肠癌组织中MTA1蛋白及mRNA的表达较直肠息肉组显著增加(P<0.05),MTA1表达与直肠癌淋巴结转移、Dukes临床分期密切相关(P<0.05)。MTA1阳性表达与生存率负相关(P<0.05)。结论 MTA1高表达促进直肠癌淋巴结转移,检测MTA1表达可成为直肠癌预后不良的重要指标。     

肺癌组织及淋巴管E-cadherin、β-catenin和LYVE-1的表达

目的观察肺癌组织E-cadherin和β-catenin的表达,LYVE-1特异性标记淋巴管;探讨钙黏蛋白及其受体在癌细胞淋巴道转移中的作用。方法取肺癌手术材料30例,通过免疫组化法,观察E-cadherin、β-catenin和LYVE-1在癌细胞及淋巴管的表达。结果癌细胞对E-cadherin、β-catenin呈阳性表达,低分化组、有淋巴结转移组E-cadherin表达减弱。淋巴管对LYVE-1阳性表达,E-cadherin阴性表达,β-catenin弱阳性表达。结论LYVE-1在淋巴管特异性表达;E-cadherin表达与肿瘤分化程度和有无淋巴结转移呈负相关;E-cadherin/β-catenin复合物对肿瘤细胞与淋巴管内皮细胞的黏附不起主要作用。     

人胰腺癌淋巴管的分布及形态观察

目的观察人胰腺癌淋巴管的分布及形态结构,探讨胰腺癌淋巴道转移机制。方法取手术后人胰腺癌标本21例,应用免疫组化染色法LYVE-1标记淋巴管进行淋巴管计数,半薄切片光镜观察和超薄切片透射电镜观察胰腺癌组织淋巴管的形态及分布特点。结果胰腺癌组织中LYVE-1染色阳性的脉管具有淋巴管的形态学特征,可见癌周组织的微淋巴管数量较癌旁"正常区"有所增加(P<0.01);半薄切片光镜下可见癌周边区和"正常区"淋巴管存在,癌中心区未见有淋巴管;电镜下癌周边区淋巴管内皮细胞连接开放,部分内皮细胞破裂溶解,管壁不完整。淋巴管内皮细胞的线粒体、高尔基体等细胞器改变。结论胰腺癌组织淋巴管主要位于癌周围浸润区的纤维结缔组织中,且淋巴管数量较癌旁"正常区"增多,淋巴管内皮超微结构改变。胰腺癌淋巴管转移可能通过增多的淋巴管的内皮连接开放和对内皮细胞的破坏溶解作用进入淋巴管管壁。     

小鼠恶性黑色素移植瘤模型的建立及其淋巴管内皮细胞透明质酸受体1的表达

目的:建立小鼠皮肤恶性黑色素移植瘤模型,探讨小鼠皮肤恶性黑色素移植瘤组织内淋巴管的生成情况。方法:体外培养B16瘤细胞,接种B16瘤细胞于C57BL/6小鼠右侧背部皮内,构建C57BL/6小鼠皮肤恶性黑色素移植瘤模型;应用H-E染色、淋巴管内皮细胞透明质酸受体1(1ymphatic vessel endothelial hyaluronan receptor-1, LYVE-1)免疫组化染色确认模型和观察肿瘤组织内淋巴管的生成情况。结果:建立了恶性黑色素移植瘤模型;LY- VE-1主要着色于正常组织和移植瘤组织中淋巴管内皮细胞的细胞膜上;恶性黑色素瘤组织中淋巴管密度明显高于正常皮肤组织。结论:构建C57BL/6小鼠皮肤恶性黑色素移植瘤模型是获得恶性黑色素瘤组织和进一步研究的有效手段;LYVE-1是特异性较高的淋巴管内皮标记物;小鼠皮肤恶性黑色素移植瘤组织中可能存在淋巴管的新生。     

Histopathological predictor for regional lymph node metastasis in gastric cancer

Regional lymph node metastasis in gastric cancer is a definitive indicator of the patient’s prognosis. The goal of this study was to identify the predictors for lymph node metastasis among all the possible histopathological parameters, especially by conducting an objective discrimination of the lymphatic and blood vessels. A total of 210 resected primary gastric cancers with or without lymph node metastasis were evaluated based on the conventional histopathological parameters together with immunohistochemistry using antisera-recognizing lymphatic endothelial hyaluronan receptor-1 (LYVE-1), von Willebrand factor, and lymphangiogenesis promoter vascular endothelial growth factor-C (VEGF-C) antibodies. A multivariate regression analyses of the results indicated that only lymphatic invasion was a significant independent predictor of lymph node metastasis at any stage of cancer invasion. VEGF-C expression was partially related to lymph node metastasis in early gastric cancer. The identification of lymphatic invasion by LYVE-1 antibody is therefore useful to predict regional lymph node metastasis in gastric cancer.     

血管内皮生长因子-D、 微血管密度及微淋巴管密度的表达与乳腺癌临床病理特征的相关性

目的 探讨乳腺癌中血管内皮生长因子D(vascular endothelial growth factor-D,VEGF-D)及微血管密度(microvessel density,MVD)、微淋巴管密度(Lymphatic vessel density,MLD)表达情况及意义.方法 收集2009年1月至2016年5月在临沂市肿瘤医院病理科存档病例,其中乳腺癌61例,乳腺增生症23例.采用免疫组化法检测各组织VEGF-D、MVD和MLD表达.结果 乳腺癌组织中VEGF-D蛋白阳性率为62.30%,明显高于乳腺增生组织,差异有统计学意义(χ2=16.215,P<0.05);乳腺癌组织中MVD和MLD分别为(17.70±7.10)和(2.41±0.85),明显高于乳腺增生组织,差异有统计学意义(t=10.900、t=8.795,P<0.05);VEGF-D表达与乳腺癌患者年龄、肿瘤大小以及淋巴结转移无明显关系(χ2=0.394、0.032、0.244,P>0.05);MVD和MLD密度与乳腺癌患者年龄和肿瘤大小无明显差异(χ2=0.081,0.126,0.219,0.196,P>0.05);VEGF-D、MVD和MLD密度与乳腺癌组织学分级相关(χ2=13.076、23.892、10.082,P<0.05),随着组织学分级递增,VEGF-D、MVD和MLD密度明显增高;MVD和MLD在乳腺癌伴淋巴结转移中密度明显高于无淋巴结转移(t=2.481、5.791,P<0.05).结论 VEGF-D在乳腺癌组织中呈高表达,可能在乳腺癌的发生发展中起重要作用,而MVD和MLD与乳腺癌肿瘤分化、转移有一定的关系.     

Higher blood vessel density in comparison to the lymphatic vessels in oral squamous cell carcinoma

Introduction: Oral squamous cell carcinoma (OSCC) is characterized by local invasion and the development of cervical metastasis. In the tongue, an association between the invasion of the lymphatic vessels and the development of metastasis in the regional lymph nodes has been demonstrated. Moreover, invasion of the blood vessels is associated with greater recurrence and poorer prognoses. Therefore, the presence and density of lymphatic and blood vessels in intra- and peritumoral tissues should play an important role in the progression, dissemination and metastasis of carcinomas. However, the evidence regarding OSCC is inconclusive. The aim of this study was to determine the comparison and association between the lymphatic (D2-40) and blood vessel (CD34) densities in intratumoral OSCC tissue. Materials and Methods: Thirty-seven cases diagnosed as OSCC between the years 2000 and 2008 were obtained from the Anatomic Pathology Service of the School of Dentistry, University of Chile. The immunohistochemical markers D2-40 and CD34 were used, and the densities (mm²) of lymphatic vessels (LVD) and blood vessels (BVD) in the intratumoral region were determined. The relationship between LVD and BVD values was evaluated. Results: There were significant association between the CD34 and D2-40 expression (rho=0.4, P<0.05) and between the LVD and the location in the tongue (P=0.019). The BVD was greater (128.0 vessels/mm²) than the LVD (42.9 vessels/mm²), and there was a positive correlation between the LVD and BVD. Conclusions: In OSCC, the BVD is greater than the LVD, and there is a moderate correlation between the two quantities.     

甲状腺滤泡状癌微淋巴管密度与淋巴结转移的关系

目的: 应用新型淋巴管内皮标记物D2-40分析甲状腺滤泡状癌及周围组织微淋巴管密度(MLVD)与淋巴结转移之间的关系.方法: 应用免疫组织化学Envision法检测35例甲状腺滤泡状癌和20例结节性甲状腺肿中D2-40和CD34的表达, 分别计数MLVD和微血管密度(MVD), 分析MLVD与甲状腺滤泡状癌淋巴结转移之间的关系, 同时与病变中MVD行对比观察.结果: 甲状腺滤泡状癌周围结缔组织及被膜中的MLVD和MVD与淋巴结转移有密切关系;MLVD和MVD越高淋巴结转移率越高.同时甲状腺淋巴管内的癌栓与淋巴结转移也显著相关(P<0.01).结论: 甲状腺滤泡状癌的淋巴结转移与微淋巴管及微血管的形成有密切关系, 抑制淋巴管生成, 这可能是未来甲状腺肿瘤治疗的一重要方向.     

Lymphatic vessel density in radical prostatectomy specimens

Formation of new lymphatic channels, or lymphangiogenesis, has been associated with poor prognosis in a number of human cancers. Its prognostic significance in prostate cancer is uncertain. We analyzed 122 radical prostatectomy specimens. Immunohistochemistry for lymphatic vessels was performed using a mouse monoclonal antibody reactive with an O-linked sialoglycoprotein found on lymphatic endothelium (clone D2-40, Signet Laboratories, Dedham, Mass). The mean lymphatic vessel densities (LVDs) of the 3 prostate compartments were compared. Lymphatic vessel densities were correlated with other clinical and pathologic characteristics. Mean values for intratumoral, peritumoral, and normal prostate LVD were 3.0, 5.2, and 4.8 lymphatic vessels per 200x field, respectively. The intratumoral LVD was significantly lower than the peritumoral or normal LVD (P < .001), and the LVD of the latter 2 compartments was not significantly different (P = .29). The prostate LVD did not correlate with other clinical and pathologic parameters. In conclusion, LVD is reduced in the intratumoral compartment compared with the peritumoral and normal prostate compartments, whereas the latter 2 have similar LVD. In contrast to other malignancies, quantitation of lymphangiogenesis in prostatic adenocarcinoma does not appear to offer useful prognostic information.     

Lymphatic vessel density in pulmonary adenocarcinoma immunohistochemically evaluated with anti-podoplanin or anti-D2-40 antibody is correlated with lymphatic invasion or lymph node metastases

In lung cancers, lymph node metastasis of cancer cells is one of the most important prognostic factors, and lymphatic vessel invasion (LVI) is very important in the stage preceding lymph node metastases. Recently, it has been reported that lymphatic vessel density (LVD) is associated with lymph node metastasis. The aim of the present study was to evaluate the relationship between LVD and LVI based on the immunohistochemical expression of podoplanin or D2-40, which are new specific markers for lymphatic endothelium. Using 76 cases of pulmonary adenocarcinoma, the relationship between LVD and LVI, lymph node metastases, vascular endothelial growth factor C (VEGF-C), VEGF-D or hepatocyte growth factor (HGF) expression was investigated. LVD was significantly associated with LVI, lymph node metastases and VEGF-D expression. LVI was also associated with lymph node metastases, histological subtype, VEGF-C or VEGF-D expression. High LVD, induced by VEGF-C or VEGF-D expression of cancer cells, is a good indicator of lymphatic metastases and LVI in pulmonary adenocarcinoma.     

CEACAM1和CD34蛋白表达与胃癌侵袭转移的关系

目的探讨癌胚抗原相关黏附分子1(CEACAM1)和CD34蛋白表达与胃癌侵袭转移的关系。方法免疫组化SP法检测90例胃癌组织和30名正常胃黏膜组织中CEACAM1及CD34的表达情况,分析CEACAM1和CD34标记的微血管密度(MVD)与胃癌患者临床病理特征的关系。结果 CEACAM1和CD34蛋白在胃癌中的阳性表达明显高于正常胃黏膜组织(P0.05)。CEACAM1蛋白的表达程度与肿瘤分化、侵袭深度、是否淋巴结转移及病理分期相关(P0.05),胃癌组织中MVD与肿瘤大小、分化、侵袭深度、是否淋巴结转移及病理分期相关(P0.05)。CEACAM1表达程度及CD34标记的MVD在胃癌中的表达呈正相关关系(P0.05)。结论 CEACAM1与CD34参与了胃癌的侵袭和转移,有望成为胃癌发生、发展和预后的预测指标。