乳腺癌组织中LVD、VEGF-C和MMP-9表达及其相关性

目的 检测乳腺浸润性导管癌(invasive ductal carcinoma,IDC)组织中的淋巴管密度(lymphatic vessel density,LVD)、VEGF-C及MMP-9的表达,探讨其临床意义.方法 收集80例乳腺IDC和20例乳腺增生性病变,应用免疫组化PV-6000两步法检测淋巴管内皮透明质酸受体1(LYVE-1)、VEGF-C和MMP-9的表达.结果 乳腺癌组织中LYVE-1标记的LVD、VEGF-C和MMP-9的表达明显高于乳腺增生性病变,差异均有统计学意义(P<0.01).LVD、VEGF-C与临床病理参数之间均无差异(P>0.05).MMP-9的表达水平在肿瘤直径>2 cm组和淋巴结转移阳性组明显升高(P<0.05和P<0.01);而在组织学分级之间表达的差异无统计学意义(P>0.05).LVD与VEGF-C的表达呈正相关关系(r=0.398,P<0.01);LVD和MMP-9之间无相关关系(P>0.05).结论 IDC中淋巴管生成增多,VEGF-C是乳腺癌中淋巴管生成的重要刺激因子,促进乳腺癌中淋巴管的生成;但乳腺癌淋巴管密度与淋巴道转移无关.MMP-9参与肿瘤的侵袭和转移的过程,促进乳腺癌淋巴道转移.     

贲门腺癌中VEGF-C、VEGF-D和D2-40的表达及意义

目的 以一种新的淋巴管特异标记物D2-40标记贲门腺癌(gastric cardiac adenocarcinoma, GCA)及癌周组织淋巴管,并进行淋巴管计数,研究其与VEGF-C 、VEGF-D表达的关系及其临床病理意义.方法应用免疫组化SP法检测贲门癌、癌旁及正常黏膜组织中VEGF-C、VEGF-D、D2-40的表达情况.结果 癌及癌旁组中淋巴管密度(lymphatic vessel density,LVD)明显高于正常组(P<0.05),而癌组与癌旁组间LVD统计学无明显差异.癌组织中LVD与淋巴结转移、TNM分期及肿瘤浸润深度呈正相关(P<0.01),而与分化程度无关;VEGF-C、VEGF-D在贲门癌中的表达明显高于癌旁组和正常组(P<0.01);癌组织中LVD在VEGF-C和VEGF-D表达阳性组中高于阴性组(P<0.05);LVD与VEGF-C、VEGF-D的表达呈正相关(P<0.05).结论 贲门癌及癌周间质中D2-40标记的LVD升高可能增加了贲门癌淋巴结转移的风险;D2-40、 VEGF-C、VEGF-D的联合检测可作为评估贲门癌淋巴结转移潜能的标志物,并且对其预后评估有一定的价值.     

VEGF-C及VEGFR-3在乳腺癌中的表达

目的探讨乳腺癌中血管内皮生长因子-C(VEGF-C)、血管内皮生长因子受体-3(VEGFR-3)的表达及与淋巴管生成的关系。方法采用免疫组化SP法检测57例乳腺癌组织中VEGF-C及VEGFR-3的表达,并在显微镜下记数VEGFR-3标记的脉管。结果淋巴结转移组VEGF-C的阳性率(90.48%)显著高于无淋巴结转移组(47.22%)(P<0.05);淋巴结转移组VEGFR-3阳性脉管数(7.62±1.18)显著高于无淋巴结转移组(5.27±0.96)(P<0.05);VEGF-C的阳性表达与VEGFR-3阳性脉管数呈正相关,相关系数为r为0.882(P<0.05)。结论 VEGF-C及VEGFR-3与乳腺癌的生长,淋巴管的生长及淋巴结的转移有关。     

乳腺癌淋巴管LYVE-1和PROX-1表达程度与肿瘤淋巴转移的关联性分析

目的观察乳腺浸润性导管癌患者肿瘤组织中乳腺癌淋巴管LYVE-1和PROX-1的表达程度与肿瘤淋巴转移的关联性。方法选择乳腺浸润性导管癌患者90例为实验组,以60例乳腺良性病变患者为对照组,检测实验组患者肿瘤组织LYVE-1和PROX-1的水平,与对照组患者组织的LYVE-1和PROX-1的水平进行比较;将实验组患者按转移、复发情况进行分类,观察LYVE-1和PROX-1表达与肿瘤淋巴转移的关系。结果实验组患者肿瘤组织的LYVE-1和PROX-1阳性淋巴管密度(LVD)明显高于对照组,实验组患者中有淋巴转移患者的LYVE-1和PROX-1阳性LVD明显高于无淋巴转移患者,差异具有统计学意义(P<0.05);LYVE-1和PROX-1阳性LVD之间无相关性;logistic回归分析,LYVE-1和PROX-1是肿瘤转移的相关因素,对LYVE-1、PROX-1与转移的关系绘制ROC曲线,AUC分别为0.716、0.672;按ROC曲线分析所得诊断临界值进行分组,随访观察一年,LYVE-1、PROX-1阳性LVD升高患者,淋巴转移率较高。结论乳腺浸润性导管癌患者肿瘤组织LYVE-1和PROX-1表达与淋巴管生成有关,表达程度高的患者更易发生淋巴转移。     

VEGF-C、VEGFR-3和iNOS在人乳腺癌淋巴管的表达

目的检测乳腺癌组织血管内皮生长因子-C(VEGF-C)及其受体(VEGFR-3)、iNOS基因表达的相关性及这三个基因mRNA表达水平与淋巴管密度(LVD)的相关性,为阐明乳腺癌淋巴管生成的分子机理提供实验依据。方法RT-PCR检测乳腺癌组织及正常乳腺组织VEGF-C、VEGFR-3、iNOSmRNA的表达水平;免疫组织化学染色法检测淋巴管内皮细胞上VEGFR-3的表达,测定淋巴管密度。结果乳腺癌LVD为20.35±4.23,显著高于正常对照组(P<0.05);乳腺癌组织VEGF-C、VEGFR-3、iNOSmRNA三者的表达率分别为74.0%、84.0%、82.0%,显著高于正常对照组(P<0.05);VEGF-C、VEGFR-3、iNOS阳性组中LVD分别为21.34±3.45、18.54±4.68、17.43±4.76,显著高于对照组(P<0.05)。结论VEGF-C、VEGFR-3、iNOSmRNA表达与淋巴管密度之间呈正相关,并且3者之间的表达亦具有相关性,这些基因的表达增高可能在乳腺癌淋巴管生成过程中具有重要作用。     

血管内皮生长因子C及其受体3在人恶性黑色素瘤组织内的表达及意义

目的 观察人恶性黑色素瘤组织内血管内皮生长因子C(VEGF-C)及其受体3(VEGFR-3)的表达,探讨VEGF-C和VEGFR-3在恶性黑色素瘤淋巴管生成及淋巴道转移中的作用.方法 取人恶性黑色素瘤组织48例(石蜡标本30例,术后新鲜组织18例),应用免疫组织化学和RT-PCR技术,观察VEGF-C和VEGFR-3蛋白及mRNA在恶性黑色素瘤组织内的表达情况.以淋巴管内皮透明质酸受体(LYVE-1)标记淋巴管,计数恶性黑色素瘤组织淋巴管数密度.结果 VEGF-C和VEGFR-3蛋白主要表达于恶性黑色素瘤细胞胞浆内,在肿瘤周围的血管和淋巴管内皮上也可见VEGFR-3蛋白表达,VEGF-C和VEGFR-3蛋白在淋巴结转移组恶性黑色素瘤组织内的表达水平明显高于无淋巴结转移组(P<0.05).在18例新鲜恶性黑色素瘤中,淋巴结转移组VEGF-C和VEGFR-3mRNA的表达明显高于无淋巴结转移组(P<0.01).LYVE-1表达于肿瘤间质内的淋巴管内皮细胞,淋巴结转移组恶性黑色素瘤组织中的淋巴管数密度(LMVD)为9.845±2.454,无淋巴结转移组恶性黑色素瘤组织中的淋巴管数密度为6.534±2.193,淋巴结转移组恶性黑色素瘤组织内的淋巴管数密度明显高于无淋巴结转移组(P<0.01).结论恶性黑色素瘤组织内VEGF-C表达明显增高,并通过上调其受体VEGFR-3的表达促进恶性黑色素瘤组织内淋巴管的生成,从而促进恶性黑色素瘤的淋巴道转移.     

人乳腺癌组织中VEGF-C和iNOS的表达及意义

目的研究人乳腺癌组织中血管内皮生长因子-C(vascular endothelial growth factor-C,VEGF-C)和诱生型一氧化氮合酶(inducible nitiric oxide synthase,iNOS)的表达并探讨两者的相关性。方法采用免疫组织化学SABC法检测50例乳腺癌组织和癌旁正常乳腺组织中VEGF-C和iNOS的表达,并分析其相互关系。结果 VEGF-C和iNOS在乳腺癌组织中均呈强阳性表达,而在癌旁正常组织则不表达。VEGF-C的表达与患者年龄、肿瘤大小、分化程度及临床分期无关(P>0.05),而与淋巴结转移密切相关(P<0.05)。iNOS的表达与患者年龄及肿瘤大小无关(P>0.05),而与分化程度、临床分期及淋巴结转移密切相关(P<0.05)。VEGF-C和iNOS的表达呈正相关(γ=0.43,P<0.05)。结论 VEGF-C和iNOS蛋白在乳腺癌的发生中具有协同作用,两者可能共同参与肿瘤淋巴管的生成。     

Smad4和VEGF-C的表达与乳腺癌淋巴管生成之间的关系

目的观察Smad4和血管内皮生长因子(VEGF)-C在人乳腺癌组织内的表达情况,分析Smad4和VEGF-C的表达与乳腺癌淋巴管生成及淋巴结转移之间的关系。方法取乳腺癌病例56例,其中,淋巴结转移组35例,无淋巴结转移组21例。应用免疫组化法和Western blot技术观察Smad4和VEGF-C在乳腺癌组织内的表达。以D2-40作为淋巴管内皮特异性标记物,检测乳腺癌组织内淋巴管生成情况。结果 Smad4在无淋巴结转移组的表达率明显高于其在有淋巴结转移组的表达率,Smad4表达阳性组的淋巴管数密度(LVD)明显低于Smad4表达阴性组。而VEGF-C在淋巴结转移组的表达率明显高于其在无淋巴结转移组的表达率。Smad4的表达与VEGF-C的表达呈显著的负相关性(r=-0.314)。Western blot检测结果表明,VEGF-C蛋白在有淋巴结转移乳腺癌组织中的表达量高于其在无淋巴结转移乳腺癌组织内的表达量,而Smad4在有淋巴结转移乳腺癌组织内的表达量明显低于其在无淋巴结转移组的表达量。结论 VEGF-C在乳腺癌淋巴管的发生及淋巴结转移中发挥重要作用,与Smad4的表达呈负相关,Smad4可能通过调节VEGF-C蛋白的表达而抑制乳腺癌淋巴管生成和淋巴道转移的作用。     

VEGF-A和C在人结肠癌淋巴管生成和淋巴道转移中的作用

目的分析血管内皮生长因子(VEGF)-A和VEGF-C在人结肠癌组织的表达及与结肠癌淋巴管生成和淋巴道转移的关系。方法取人结肠癌组织91例,应用免疫组化方法检测VEGF-A和VEGF-C在结肠癌组织中的表达。应用D2-40标记结肠癌组织的淋巴管,观察结肠癌组织的淋巴管生成情况。结果结肠癌组织中VEGF-A和VEGF-C的表达水平明显高于正常组织,VEGF-A和VEGF-C表达阳性的结肠癌组织的淋巴管密度(LVD)明显高于阴性组织,VEGF-A和VEGF-C的表达及LVD均与淋巴结转移及Duke's分期相关。结论结肠癌组织VEGF-A和VEGF-C过表达与结肠癌的淋巴管生成和淋巴道转移相关。     

乳腺浸润性导管癌中COX-2、VEGF-C和VEGFR-3的表达及其意义

目的本研究通过检测乳腺癌组织中COX-2、VEGF-C和VEGFR-3的表达及其意义,探讨其在乳腺癌淋巴管转移中的发生发展机制。方法采用免疫组化SP法检测60例乳腺癌组织标本(有腋窝淋巴结转移组27例,无腋窝淋巴结转移组33例)中COX-2、VEGF-C和VEGFR-3的表达。结果乳腺癌组织中COX-2、VEGF-C和VEGFR-3的阳性表达明显高于正常乳腺组织,差异有统计学意义(P0.01)。淋巴结转移组COX-2和VEGF-C阳性表达明显高于无淋巴结转移组,差异有统计学意义(P0.01、P0.05)。淋巴结转移组VEGFR-3阳性脉管数明显高于无淋巴结转移组,差异有统计学意义(P0.01)。结论乳腺癌组织中COX-2、VEGF-C和VEGFR-3的阳性表达明显高于正常乳腺组织;COX-2、VEGF-C和VEGFR-3的阳性表达与乳腺癌淋巴道转移密切相关。     

The extent of retraction clefts correlates with lymphatic vessel density and VEGF-C expression and predicts nodal metastasis and poor prognosis in early-stage breast carcinoma

Although the earliest feature of disseminated disease in breast cancer is regional lymph node involvement, little is known about the mechanisms whereby cancer cells interact with lymphatic endothelial cells and enter the lymphatic system. We have previously reported that the extensive presence of retraction clefts in breast carcinomas highly significantly correlates with lymphatic tumor spread and predicts poor outcome, suggesting that retraction clefts are not just fixation artifacts, but real potential spaces that are exaggerated by tissue processing and may reflect an early stage of lymphatic invasion. In this study, we examined the correlation between the extent of retraction clefts and lymphangiogenesis, as assessed by lymphatic vessel density and vascular endothelial growth factor-C (VEGF-C) expression in a series of 256 early-stage breast carcinomas. The presence and extent of retraction clefts around tumor cell nests was determined by review of all hematoxylin- and eosin-stained tumor sections. Lymphatic vessels were detected by podoplanin immunohistochemistry and lymphatic vessel density was measured using the hot-spot method. The expression of VEGF-C in the tumor cells was determined by immunohistochemistry and analyzed semiquantitatively on a four-tiered scale. High levels of retraction clefts, peritumor lymphatic vessel density and VEGF-C expression at the invasive edge in breast carcinomas significantly correlated with tumor size, histological grade, lymphatic invasion and nodal metastasis. Breast carcinomas showing extensive retraction clefts (>20% of tumor volume) were found to have significantly higher lymphatic vessel density and VEGF-C expression levels compared to tumors without this feature. High retraction clefts, peritumor lymphatic vessel density and VEGF-C expression predicted poor outcome in breast carcinomas. Our results support the hypothesis that retraction clefts are real potential spaces that may represent 'pre-lymphatic spaces' facilitating initial lymphatic invasion and that growth factors secreted by the tumor cells may stimulate tumor-associated lymphangiogenesis by promoting the endothelialization of these 'pre-lymphatic channels'.     

Expression of vascular endothelial growth factor-C and its receptor in invasive micropapillary carcinoma of the breast

Invasion to lymphatic vessels and metastasis to lymph nodes are frequent complications in invasive micropapillary carcinoma (IMPC) of human breast cancer. Vascular endothelial growth factor-C (VEGF-C) and its receptor, VEGFR-3 have been implicated as the important factors in the formation of lymphatic vessels and recent experimental evidence strongly suggests that lymphangiogenesis in tumor promotes lymphatic metastasis. To clarify the mechanism of its occurrence, the expression of VEGF-C, VEGFR-3 and lymphatic vessel density (LVD) was examined in 40 cases of IMPC (pure and mixed type) and in 40 cases of pseudo-IMPC. Cytoplasmic expression of VEGF-C and VEGFR-3 were more frequent in tumor cells of IMPC compared to those of pseudo-IMPC. A significant positive correlation was found between the expression of VEGF-C and VEGFR-3 in both IMPC and pseudo-IMPC. The expression of VEGF-C was also significantly associated with higher peritumoral LVD, lymphatic invasion and number of lymph node metastasis in IMPC. These findings suggest that VEGF-C promotes the proliferation of peritumoral lymphatic vessels and that lymphatic invasion and metastasis to lymph nodes are frequently induced in IMPC of breast.     

VEGF-D in association with VEGFR-3 promotes nodal metastasis in human invasive lobular breast cancer

We assessed the expression of vascular endothelial growth factors (VEGF-C and VEGF-D) in breast cancer cells and the density of lymph vessels and VEGF receptor-3 (VEGFR-3)-positive vessels in and around the tumor in invasive lobular breast cancer. We found significant correlation between peritumoral lymph vessel density and presence of lymph node metastases (P=.001) and the number of metastatic lymph nodes (P<.001). A significant correlation was detected between tumor cell VEGF-D expression and lymph node status (P=.001) and density of lymphatic vessel endothelial receptor (LYVE)-1-positive vessels (P=.035). VEGFR-3+/VEGF-D+ and VEGFR-3+/VEGF-C+ tumors had a significantly higher number of metastatic lymph nodes than tumors with other staining patterns (P<.001). Tumors positive for neither VEGF-D nor VEGFR-3 had a lower density of LYVE-1+ vessels than tumors with other staining patterns (P=.033). Our results indicate that peritumoral lymph vessel density is associated with lymph node metastases in invasive lobular breast cancer and that invasive lobular cancer producing VEGF-D, surrounded by VEGFR-3+ vessels, has a significantly higher peritumoral lymph vessel density and a higher number of metastatic lymph nodes.     

表没食子儿茶素-3-没食子酸酯抑制乳腺癌裸鼠移植瘤淋巴管生成

目的 探讨表没食子儿茶素-3-没食子酸酯(EGCG)对人乳腺癌裸鼠皮下移植瘤淋巴管生成的影响及其作用机制.方法 建立裸鼠皮下移植瘤模型30例,随机分成5组,即生理盐水组、5-氟脲嘧啶(5-FU)组、20mg/kg EGCG组、10mg/kg EGCG组、5mg/kg EGCG组,观察瘤组织血管内皮生长因子C(VEGF-C)的表达情况,淋巴管内皮细胞透明质酸受体1(LYVE-1)标记淋巴管,检测淋巴管密度及面积;Western blotting检测移植瘤组织VEGF-C蛋白的表达情况.结果 免疫组织化学染色VEGF-C在20mg/kg EGCG处理组中的表达量明显低于生理盐水组和5-FU组,且VEGF-C的表达与EGCG成剂量依赖性;移植瘤周边淋巴管密度、面积在20mg/kg EGCG处理组中显著低于5-FU组和生理盐水组,差异有统计学意义;Western blotting结果显示,EGCG高剂量处理组VEGF-C蛋白明显低于生理盐水组.结论 EGCG可以抑制乳腺癌裸鼠移植瘤中VEGF-C的表达及淋巴管的生成.     

基质金属蛋白酶2和9及血管内皮生长因子C在乳腺癌淋巴结转移中的作用

目的 研究血管内皮生长因子C(VEGF-C)与基质金属蛋白酶(MMP)-2、MMP-9在乳腺癌组织中的表达及三者在乳腺癌淋巴结转移中的作用.方法 应用免疫组织化学SP法对84例乳腺癌(有腋淋巴结转移者52例,无腋淋巴结转移者32例)的VEGF-C、MMP-2和-9以及血管内皮透明质酸受体-1(LYVE-1)的表达进行检测,统计分析VEGF-C、MMP-2和-9与乳腺癌淋巴管生成的关系.利用重组质粒表达载体介导的短发夹式干扰RNA(shRNA)靶向沉默乳腺癌MCF-7细胞株中VEGF-C基因,PCR检测VEGF-C、MMP-2和-9的表达.结果 VEGF-C与MMP-2和-9在乳腺癌组织中均呈过表达,分别为83.3%(70/84)、89.3%(75/84)和75.0%(63/84),且在腋淋巴结转移组[94.2%(49/52)、98.1%(51/52)和88.5%(46/52)]比无淋巴结转移组[65.6%(21/32)、75.0%(24/32)和53.1%(17/32)]明显高表达(P＜0.05);淋巴管密度在腋淋巴结转移组及无转移组的表达有统计学意义(P＜0.05),随着VEGF-C与MMP-2和-9表达强度增加,淋巴管数量也增加(P＜0.05);转染重组质粒后MCF-7细胞株的VEGF-C及MMP-2和-9的mRNA表达水平下调,抑制率分别为95.0%、53.0%和77.0%(P＜0.05).结论 VEGF-C与MMP-2和-9协同促进乳腺癌组织的淋巴管新生和乳腺癌淋巴结转移.     

VEGF-C在卵巢癌局部淋巴结内淋巴管生成中的作用

目的观察血管内皮生长因子-C(VEGF-C)在卵巢癌组织内的表达,分析其与卵巢癌局部淋巴结内淋巴管生成之间的关系。方法取卵巢癌64例,其中,有淋巴结转移40例,无淋巴结转移24例。应用免疫组化法和Western blot技术观察VEGF-C在卵巢癌组织内的表达。以D2-40作为淋巴管内皮特异性标记物,检测卵巢癌局部淋巴结内淋巴管生成情况。结果 VEGF-C主要表达于卵巢癌细胞浆和胞膜以及癌组织周围浸润的炎性细胞,在有淋巴结转移组的表达率明显高于其在无淋巴结转移组的表达率。Western blot检测结果表明,VEGF-C蛋白在有淋巴结转移的卵巢癌组织中的表达量高于其在无淋巴结转移的卵巢癌组织内的表达量。D2-40表达于卵巢癌局部淋巴结内的淋巴管内皮细胞,在有转移的淋巴结内可见大量新生的淋巴管,淋巴管腔内存在入侵的肿瘤细胞,在无转移的淋巴结内观察到新生的淋巴管。在无淋巴结转移组病例中,卵巢癌组织VEGF-C阳性者局部淋巴结内淋巴管密度明显高于VEGF-C阴性者淋巴结内的淋巴管密度。结论 VEGF-C的表达与卵巢癌淋巴结转移密切相关,卵巢癌在发生局部淋巴结转移之前存在淋巴结内淋巴管生成的现象,卵巢癌组织内VEGF-C的表达在卵巢癌局部淋巴结内的淋巴管生成中可能发挥重要作用。     

VEGF-C表达与胰腺癌淋巴结转移及预后的关系

目的 观察血管内皮生长因子(VEGF)-C在胰腺癌组织内的表达情况,分析VEGF-C的表达与胰腺癌淋巴结转移和预后之间的关系。方法 取胰腺癌病例52例,其中,伴淋巴结转移组36例,无淋巴结转移组16例。应用免疫组化法和Western blot技术观察VEGF-C在胰腺癌组织内的表达。以D2-40作为淋巴管内皮特异性标记物,观察胰腺癌组织内淋巴管生成的情况。采用Kaplan-Meier法绘制生存曲线判断VEGF-C的表达对胰腺癌预后的影响。结果 Western blot和免疫组化法检测结果表明,VEGF-C主要表达于胰腺癌细胞浆内,淋巴结转移组阳性表达量明显高于无淋巴结转移组(p<0.05)。D2-40表达于胰腺癌组织内淋巴管内皮细胞,VEGF-C阳性组淋巴管数密度明显高于VEGF-C阴性组(p<0.05),表明VEGF-C的表达与胰腺癌淋巴管生成密切相关。Kaplan-Meier生存分析表明VEGF-C表达阴性患者的生存率均高于VEGF-C表达阳性患者,VEGF-C的表达影响患者的预后。结论 VEGF-C在胰腺癌的淋巴管生成和淋巴结转移过程中发挥重要作用,VEGF-C的表达是影响胰腺癌患者预后的主要因素之一。     

Smad4的表达与卵巢癌淋巴管生成及淋巴结转移之间的关系

目的观察Smad4和血管内皮生长因子(VEGF)-C在卵巢癌组织内的表达情况,分析Smad4和VEGF-C的表达与卵巢癌淋巴管生成及淋巴结转移之间的关系。方法取卵巢癌病例60例,其中,淋巴结转移组36例,无淋巴结转移组24例。应用免疫组化法和Westernblot技术观察Smad4和VEGF-C在卵巢癌组织内的表达。以D2-40作为淋巴管内皮特异性标记物,检测卵巢癌组织内淋巴管生成情况。结果 Smad4表达于卵巢癌细胞胞浆和胞核内,其在无淋巴结转移组的表达率明显高于其在有淋巴结转移组的表达率。Smad4表达阳性组的淋巴管数密度(LVD)明显低于Smad4表达阴性组的LVD。VEGF-C主要表达于卵巢癌细胞胞浆内,其在淋巴结转移组的表达率明显高于其在无淋巴结转移组的表达率。Smad4的表达与VEGF-C的表达呈显著的负相关性。Western blot检测结果表明,VEGF-C蛋白在有淋巴结转移卵巢癌组织中的表达量高于其在无淋巴结转移卵巢癌组织内的表达量,而Smad4在有淋巴结转移卵巢癌组织内的表达量明显低于其在无淋巴结转移组的表达量。结论 Smad4与VEGF-C的表达呈负相关,Smad4可能通过调节VEGF-C蛋白的表达而抑制卵巢癌淋巴管生成和淋巴道转移。     

Lymphatic spread is related to VEGF-C expression and D2-40-positive myofibroblasts in intrahepatic cholangiocarcinoma.

Lymph node metastasis via lymphatic vessels is related with an adverse outcome in many tumors. It is unclear whether lymphatic spread needs the development of the new lymphatic vessels or the expression of lymphangiogenetic factor in intrahepatic cholangiocarcinoma. The aim of this study was to assess the role of lymphangiogenesis, vascular endothelial growth factor-C (VEGF-C) expression, and D2-40-positive myofibroblastic cells for lymphatic spread and patient outcome in 88 cases of intrahepatic cholangiocarcinoma. We also assessed VEGF-C expression in 15 cases of metastatic lymph nodes. There was a significant correlation between lower lymphatic vessel density in the tumor center and positive lymphatic invasion (P=0.0100). Poorly differentiated cholangiocarcinoma showed higher lymphatic vessel density in the tumor periphery and in the peritumoral area (P=0.0315 and P=0.0360, respectively). Lymphatic invasion was observed higher in the peritumoral area (63%, 24/38) and in the tumor periphery (79%, 30/38) than in the tumor center (27%, 9/38). There was no significant correlation between the proliferative lymphatic vessels and pathologic features; however, lymphatic invasion was significantly associated with VEGF-C expression (P=0.0006), and the VEGF-C expression was seen in 12 of 15 cases (80%) of metastatic lymph node. Nodal metastasis was correlated with D2-40-positive myofibroblasts (P=0.0161). VEGF-C expression was an independent prognostic factor by multivariate survival analysis (P=0.0131). Our findings suggest that VEGF-C has an important role in lymphatic invasion via the preexisting lymphatic vessels in the tumor margin, and that lymphangiogenesis does not play a direct role in lymphatic metastasis. D2-40-positive myofibroblasts may contribute to lymphatic metastasis.