Vascular endothelial growth factor-C (VEGF-C) expression predicts lymph node metastasis of transitional cell carcinoma of the bladder

PURPOSE: It has been found that expression of vascular endothelial growth factor-C (VEGF-C) in several carcinomas is significantly associated with angiogenesis, lymphangiogenesis and regional lymph node metastasis. However, VEGF-C expression in bladder transitional cell carcinoma (TCC) has not yet been reported. To elucidate the role of VEGF-C in bladder TCC, we examined VEGF-C expression in bladder TCC and pelvic lymph node metastasis specimens obtained from patients who underwent radical cystectomy. METHODS: Eighty-seven patients who underwent radical cystectomy for clinically organ-confined TCC of the bladder were enrolled in the present study. No neoadjuvant treatments, except transurethral resection of the tumor, were given to these patients. The VEGF-C expressions of 87 bladder tumors and 20 pelvic lymph node metastasis specimens were examined immunohistochemically and the association between VEGF-C expression and clinicopathological factors, including angiogenesis as evaluated by microvessel density (MVD), was also examined. RESULTS: Vascular endothelial growth factor-C expression was found in the cytoplasm of tumor cells, but not in the normal transitional epithelium. Vascular endothelial growth factor-C expression was significantly associated with the pathological T stage (P = 0.0289), pelvic lymph node metastasis (P < 0.0001), lymphatic involvement (P = 0.0008), venous involvement (P = 0.0002) and high MVD (P = 0.0043). The multivariate analysis demonstrated that VEGF-C expression and high MVD in bladder TCC were independent risk factors influencing the pelvic lymph node metastasis. Moreover, the patients with VEGF-C-positive tumors had significantly poorer prognoses than those with the VEGF-C-negative tumors (P = 0.0087) in the univariate analysis. The multivariate analysis based on Cox proportional hazard model showed that the independent prognostic factors were patient age (P = 0.0132) and pelvic lymph node metastasis (P = 0.0333). CONCLUSION: The present study suggests that VEGF-C expression is an important predictive factor of pelvic lymph node metastasis in bladder cancer patients.     

膀胱移行细胞癌中VEGF-C的表达与患者预后的关系

目的:探讨血管内皮生长因子C(VEGF-C)在膀胱移行细胞癌(BTCC)中的表达及与预后的关系.方法:采用免疫组化方法研究45例膀胱移行细胞癌中VEGF-C的蛋白水平的表达,并分析该45例患者的预后随访情况;评估VEGF-C表达与淋巴管浸润、淋巴结转移等临床病理资料和预后的相关性.结果:Kaplan-Meier 生存曲线和Logrank test生存率显示VEGF C高表达组生存率低于VEGF C低表达组(P＜o.05);COX回归多因素分析发现淋巴结转移是患者预后不良的危险因素(P＜0.05).结论:检测膀胱移行细胞癌VEGF C表达能够预示盆腔淋巴结是否转移;VEGF-C通过促进肿瘤淋巴道的浸润和转移影响疾病的进展,可能成为一项新的预后判断指标;其表达情况可以提示患者术后是否必要进行辅助治疗.     

淋巴管内皮生长因子-C在膀胱移行细胞癌中的表达及其临床意义

目的 :探讨具有促进淋巴管内皮细胞增殖和毛细淋巴管增生的淋巴管内皮生长因子 C(VEGF C)在膀胱移行细胞癌 (BTCC)中的表达及其与肿瘤淋巴管浸润、淋巴结转移等临床病理因素的关系。方法 :采用免疫组织化学方法研究 4 5例BTCC中VEGF C的表达水平 ,观察评估VEGF C的阳性表达与淋巴管浸润、淋巴结转移等临床病理资料的相关性。结果 :4 5例中 ,VEGF C阳性 36例 ,VEGF C的阳性表达与肿瘤分级、分期、静脉或淋巴管浸润、淋巴结及前列腺侵犯明显相关 (P <0 .0 5 ) ;多因素分析显示VEGF C的表达是唯一影响盆腔淋巴结转移的独立因素 (P =0 .0 0 3)。结论 :VEGF C与BTCC淋巴管浸润和转移有显著相关性 ,检测BTCC中VEGF C的表达能够预示盆腔淋巴结是否转移。     

Prognostic significance of vascular invasion in patients with bladder cancer who underwent radical cystectomy

BACKGROUND: The objective of this study was to determine whether vascular invasion (i.e. lymphatic and blood vessel invasion) could be a useful prognostic predictor in patients with locally invasive transitional cell carcinoma (TCC) of the bladder who underwent radical cystectomy. METHODS: This series included 114 consecutive patients undergoing radical cystectomy for primary TCC of the bladder between November 1989 and July 2003. Several clinicopathological characteristics of these patients were analyzed, focusing on the association between vascular invasion and disease recurrence after radical cystectomy. RESULTS: Lymphatic and blood vessel invasions were detected in 55 (48.2%) and 33 (29.8%) specimens, respectively. Lymphatic invasion was significantly associated with pathological stage, tumor grade, lymph node metastasis, blood vessel invasion and disease recurrence, whereas blood vessel invasion was significantly related to pathological stage, lymph node metastasis, lymphatic invasion and disease recurrence. Recurrence-free survival in patients with lymphatic invasion was significantly lower than that in those without lymphatic invasion, and a similar significant difference in recurrence-free survival was observed between patients with and without blood vessel invasion. However, multivariate analysis using the Cox proportional hazards model showed that only pathological stage and lymph node metastasis could be used as independent predictors for disease recurrence after radical cystectomy. CONCLUSIONS: Despite a significant association between several prognostic parameters, vascular invasion was not an independent predictor of disease recurrence; therefore, if there are other conventional parameters available, there might not be any additional advantage to considering the presence of vascular invasion when predicting the prognosis of patients undergoing radical cystectomy for TCC of the bladder.     

Lymph node metastases in non-muscle invasive bladder cancer are correlated with the number of transurethral resections and tumour upstaging at radical cystectomy

The first paper in this section, from Mainz, attempts to identify the clinical variables associated with the prevalence of lymph node metastases in non-muscle invasive bladder cancer. The authors found that delay in cystectomy in this potentially dangerous type of tumour is to be avoided, with a higher incidence of lymph node metastases as the number of transurethral resections increases. A paper from Austria shows that in renal carcinoma the pT1 subdivision is associated with differences in conventional histopathology and expression of biomarkers. OBJECTIVE: To identify clinical variables associated with the prevalence of lymph node metastases (LNMs) in patients with non-muscle invasive transitional cell carcinoma (TCC) of the bladder treated with radical cystectomy. PATIENTS AND METHODS: Of 866 patients treated by radical cystectomy and pelvic lymphadenectomy between 1989 and 2002, 219 had non-muscle invasive TCC of the bladder. A retrospective evaluation of these patients included univariate and multivariate analyses of sex, age, number of transurethral resections of the bladder tumour (TURBTs), interval between first TURBT and cystectomy, adjuvant therapy, maximum histopathological tumour stage and grade at TURBT, and tumour upstaging in the cystectomy specimen. RESULTS: LNMs were diagnosed in 33 patients (15%). After multivariate analysis modelling, the number of TURBTs and tumour upstaging in the cystectomy specimen were correlated with the prevalence of LNMs at cystectomy. The number of TURBTs increased the prevalence of LNMs from 8% in patients with one TURBT to 24% in those with two to four TURBTs. Tumour upstaging in the cystectomy specimen increased the prevalence of LNMs from 4% to 36%. CONCLUSION: Inappropriate delay and inadequate staging of high-grade non-muscle invasive TCC of the bladder are to be avoided. The present multivariate analysis showed that the number of TURBTs and tumour upstaging in the cystectomy specimen correlated with an increased prevalence of LNMs.     

Clinicopathological Features of Recurrence after Radical Cystectomy for Patients with Transitional Cell Carcinoma of the Bladder

Background: The objective of this study was to investigate the clinicopathological features of recurrent transitional cell carcinoma (TCC) of the bladder in patients who had previously undergone radical cystectomy. Materials and methods: This study included 124 patients who underwent radical cystectomy for transitional cell carcinoma (TCC) of the bladder in our institution. Several clinicopathological factors were analyzed to characterize differences between patients with and without disease recurrence, and determined predictive factors for disease recurrence using multivariate analysis. We further analyzed prognostic parameters that affect survival after disease recurrence was diagnosed. Results: Of the 124 patients, 24 (19.5%) developed recurrence, and the median time to recurrence was 9.5 months (range, 1–44 months). The 5-year recurrence-free survival in these 124 patients was 75.6%. The incidence of disease recurrence was significantly associated with gender, pathological stage, lymph node metastasis, lymphatic invasion and blood vessel invasion. Multivariate analysis identified gender, pathological stage and lymph node metastasis as independent predictors of disease recurrence following radical cystectomy. After disease recurrence, the 1-year cancer-specific survival of the 24 patients was 16.7%; that is, 23 of the 24 patients had died of progressive recurrent diseases, while the remaining 1 who survived had developed recurrence in the upper urinary tract. Conclusions: These findings suggest that careful follow-up should be performed after radical cystectomy for TCC of the bladder considering gender, pathological stage and nodal involvement; however, once recurrent disease develops, the prognosis of such patients is extremely poor. Therefore, it would be potentially important to establish a multimodal therapeutic approach targeting recurrent TCC of the bladder.     

膀胱癌合并上尿路积水患者行根治术的预后分析

目的 探讨术前合并上尿路积水对根治性膀胱切除患者预后的影响.方法 回顾性分析从2003年1月至2010年5月期间126例行根治性膀胱切除术患者的资料,上尿路积水39例(31.0%),单因素分析上尿路积水对膀胱癌患者术后无复发生存率的影响,多因素分析上尿路积水、病理T分期和盆腔淋巴结转移情况等因素对膀胱癌根治术患者术后预...     

FLOW CYTOMETRIC DETERMINATION OF THE DNA CONTENT IN TRANSITIONAL CELL CARCINOMA OF THE BLADDER: PREDICTABILITY OF PLOIDYWITH REGARD TO PELVIC LYMPH NODE METASTASIS

Flow cytometry was used to evaluate 93 deparaffinized transurethral resection or cystectomy specimens to investigate the predictability of DNA profiles with regard to pelvic lymph node metastasis. The pathological stage and grade were also compared with the status of the pelvic lymph node. The incidence of aneuploidy in the total specimen group was 55 out of 93 (59%). Aneuploidy and pathologic stage were significant risk factors for pelvic lymph node metastasis (p = 0.0091, 0.0008 respectively) but histologic grade was not correlated with pelvic lymph node status (p = 0.7418). Aneuploidy was noted in all of the 11 specimens exhibiting lymph node involvement compared with 44 of the 82 (54%) without lymph node involvement (p=0.0091). There was no positive pelvic lymph node involvement in patients with diploid tumor compared with 11 of the 55 (20%) patients with aneuploid tumors. In conclusion, the recognition of a DNA aneuploid stemline in a primary transitional cell carcinoma of the bladder is statistically correlated with a greater likelihood of pelvic lymph node metastasis. This suggests that preoperative DNA flow cytometry for primary tumor might be helpful in selecting patients who should be offered additional treatment such as neoadjuvant chemotherapy before definitive treatment or a more conservative approach such as transurethral resection.     

VEGF-C、VEGFR-3在NSCLC中的表达与淋巴转移

目的 探讨VEGF-C及VEGFR-3与NSCLC淋巴转移间的关系,为了解患者预后提供依据。方法 采用免疫组化法检测65例NSCLC中VEGF-C及VEGFR-3的表达,结合临床病理特征进行分析。结果 NSCLC中VEGF-C和VEGFR-3的阳性率明显高于正常肺组织(P0.05)。二者在Ⅲ期NSCLC中的表达率明显高于Ⅰ、Ⅱ期,且随病理分级的增高而显著增加(P0.05),在有淋巴结转移者明显高于无淋巴结转移者(P0.05)。结论 VEGF-C及VEGFR-3在NSCLC中高表达,与其临床分期、病理分级、病理类型和淋巴结转移均密切相关。     

Clinical outcomes following radical cystectomy for primary nontransitional cell carcinoma of the bladder compared to transitional cell carcinoma of the bladder

PURPOSE: The effect of bladder cancer histological subtypes other than transitional cell carcinoma (nonTCC) on clinical outcomes remains uncertain. We conducted a multi-institutional retrospective study of patients with bladder cancer treated with radical cystectomy to assess the impact of nonTCC histology on bladder cancer specific outcomes. MATERIALS AND METHODS: A total of 955 consecutive patients underwent radical cystectomy with bilateral pelvic lymphadenectomy for bladder cancer at 3 academic institutions. TCC was present in the radical cystectomy specimen in 888 patients (93%). NonTCC histology was present in 67 patients (7%), including squamous cell carcinoma in 26, adenocarcinoma in 13, small cell carcinoma in 10 and other nonTCC subtypes (ie spindle cell carcinoma, carcinosarcoma and undifferentiated carcinoma) in 18. For patients alive at last followup median followup was 39 and 23 months for patients with TCC and nonTCC histologies, respectively. Bladder cancer specific progression and survival were assessed using Kaplan-Meier and multivariate Cox proportional hazards analyses. RESULTS: Bladder cancer specific progression and mortality did not differ significantly between patients with SCC and TCC histologies. Patients with nonTCC and nonSCC bladder cancer were at significantly increased risk for progression and death compared to patients with TCC or SCC (p <0.001). This association remained statistically significant in patients with organ confined disease (stage pT2 or lower) and patients with nonorgan confined disease (stage pT3 or higher) (p <0.001). In a multivariate analysis nonTCC and nonSCC histology was associated with an increased risk of bladder cancer progression and death (OR 2.272 and 2.585, respectively, p <0.001), even after adjusting for final pathological stage, lymph node status, lymphovascular invasion and neoadjuvant or adjuvant treatments. CONCLUSIONS: NonTCC and nonSCC histological subtype is an independent predictor of bladder cancer progression and mortality in patients undergoing radical cystectomy for bladder cancer. Patients with bladder TCC and SCC share similar stage specific clinical outcomes.     

pN0食管癌Ivor-Lewis手术后淋巴结转移性复发的危险因素

目的 探讨pN0期食管癌病人Ivor-Lewis手术后淋巴结转移性复发的危险因素.方法 对2001年1月至2005年1月间接受Ivor-Lewis手术治疗的82例pN0期胸中段食管鳞癌病人进行前瞻性研究,用RT-PCR检测食管癌组织中淋巴管生成因子C(VEGF-C)mRNA和淋巴结组织中上皮标志物(Mucin1)mRNA的表达;Kaplan-Meier法计算复发率;Log-rank检验比较复发率;Cox回归多因素分析判定独立的危险因素.结果 42例食管癌组织中检测到VEGF-C mRNA表达;23例至少在1枚淋巴结中检测到Mucin1 mRNA表达,诊断为淋巴结微转移;手术后3年内37例发生淋巴结转移;T分期与病人3年内淋巴结转移的发生率相关(P＜0.05);有VEGF-C mRNA表达者3年内淋巴结转移发生率显著高于无VEGF-C mRNA表达者(P＜0.01);有淋巴结微转移者3年内淋巴结转移的发生率显著高于无淋巴结微转移者(P＜0.01).Cox回归分析显示T分期、食管癌组织中VEGF-C mRNA表达和淋巴结微转移是病人手术后3年内淋巴结转移的独立危险因素.结论 T分期、食管癌组织中VEGF-C mRNA表达和淋巴结微转移是pN0食管癌病人Ivor-Lewis手术后淋巴结转移性复发的独立危险因素.

Abstract：

Objective To investigate the risk factors with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy. Methods The subjects were 82 patients with pN0 esophageal cancer who underwent Ivor-Lewis esophagectomy from January 2001 to January 2005. By using RT-PCR, VEGF-C mRNA was detected in tumor issues, and Mucin l( MUC1 )mRNA was detected in lymph nodes. The Kaplan-Meier method was used to calculate the survival rate and lymph nodal metastatic rate. Log-rank test was performed to compare the recurrence rate, and Cox regression multivariate analysis was performed to determine independent prognostic factors. Results VEGF-C mRNA was identified in 42 patients (51.22%), and MUC1 mRNA was identified in 23 patients(28.05% )from at least 1 lymph node station . The diagnosis of lymph node micrometastasis (LNMM) was based on the detection of MUC1 mRNA. The first recurrence exhibiting lymph node metastasis was recognized in 37 patients (45.1%) at the first 3 years after operation and this was significantly associated with T status ( P ＜ 0. 05 ). Lymph node metastatic rate for patients with VEGF-C mRNA expression in tumor issues was significantly higher than that for patients without VEGF-C mRNA expression( P ＜0. 01 ). And lymph node metastatic rate for patients with LNMM was significantly higher than that for patients without LNMM ( P ＜0. 01 ). The results of multivariate analysis confirmed that T status, VEGF-C mRNA expression in tumor issues and LNMM were independent relevant factors. Conclusion Status,VEGF-C mRNA expression in tumor issues and LNMM in patients with N0 esophageal cancer were independent risk factors for 3-year lymph node metastatic recurrence after Ivor-Lewis Esophagectomy.     

Prognostic significance of p27Kip1 expression in bladder cancer

The importance of markers in urological cancer is well recognised and many attempts are being made to find one which will be of prognostic significance. Authors from New York found that low expression of p27Kip1 in patients with bladder cancer was a significant predictor of pelvic recurrence, progression to metastasis and death. Authors from Switzerland examined patients with a primary solitary distal ureteric TCC; they found that distal ureteric resection in such patients is feasible, and that the long-term oncological outcome appears to be comparable to more radical treatment of this condition. OBJECTIVE: To define the prognostic significance of p27(Kip1) expression in bladder cancer for overall, disease-specific, metastasis-free and pelvic recurrence-free survival, and to identify clinical and pathological correlates of p27(Kip1) immunophenotypes. PATIENTS: AND METHODS: Tumour samples from 128 evaluable patients with bladder cancer were assessed by immunohistochemistry for p27(Kip1) and E2F-1 expression. Immunoreactivity of p27(Kip1) was correlated with clinicopathological variables, E2F-1 immunoreactivity, and outcome. Multivariate analysis was used to assess predictors of outcome. The median follow-up was 30.9 months overall and 105.7 months in the 32 patients alive at the last follow-up. RESULTS: The fraction of tumour cells with p27(Kip1) nuclear immunoreactivity was <5% in 15, 5-25% in 30, 25-50% in 19, 50-75% in 51, and > or = 75% in 13 patients. High-grade tumours and those with lower E2F-1 nuclear reactivity had a lower mean percentage p27(Kip1) reactivity (P = 0.047 and 0.011, respectively). On multivariate analysis, the percentage p27(Kip1) reactivity was a significant independent predictor of pelvic recurrence (P = 0.017), progression to metastases (P = 0.046), death from disease (P = 0.008), and death from any cause (P = 0.017), with a low expression portending a worse prognosis. Suspicion of vascular invasion was a significant independent predictor of progression to metastases (P = 0.002), death from disease, and death from any cause (both P < 0.001). Lymph node involvement was a significant independent predictor of progression to metastases (P = 0.006). CONCLUSIONS: Low expression of p27(Kip1) was a significant independent predictor of pelvic recurrence, progression to metastasis, death from disease and death from any cause, in patients with bladder cancer.     

Risk factors for mucosal prostatic urethral involvement in superficial transitional cell carcinoma of the bladder

Objective:Prostatic transitional cell carcinoma (TCC) may involve urethral mucosa, ducts, acini and stroma of the gland. In this study, we evaluated the risk factors for mucosal prostatic urethral (PU) involvement in superficial TCC of the bladder.Methods:The data of 340 consecutive male patients with the diagnosis of primary superficial TCC of the bladder who were treated at our institution were reviewed. Median age of the patients was 64 years and median follow-up was 66 months. The impact of pathological stage, grade, tumour multiplicity and presence of carcinoma in situ (CIS) on mucosal PU involvement were evaluated.Results:Twenty one patients (6.2%) had mucosal involvement of the PU and concomitant multifocal TCC of the bladder. Of those, 12 patients (3.5%) had macroscopic mucosal involvement of the PU while the other 9 patients (2.7%) had microscopic tumour. Increased pathological stage, grade and tumour multiplicity were found to be risk factors for mucosal PU involvement in patients with superficial bladder cancer. Multivariate analysis showed that only the tumour multiplicity was found to be an independent risk factor for mucosal PU involvement by TCC (p = 0.001).Conclusions:The incidence of mucosal PU involvement increases as the stage, grade and number of tumours increase in patients with superficial TCC of the bladder. We recommend PU sampling particularly in patients with multiple bladder tumours which may have an impact on further management of these patients.     

The Prognostic Significance of Metastatic Perivesical Lymph Nodes Identified in Radical Cystectomy Specimens for Transitional Cell Carcinoma of the Bladder

PurposeWe determined the prognostic significance of metastatic perivesical lymph nodes (PVLN) in transitional cell carcinoma of the bladder (TCC).Materials and MethodsA retrospective review of 198 consecutive patients who underwent radical cystectomy for clinically organ confined TCC identified 32 patients with PVLN in pathology specimens. Patient characteristics were compared. Overall survival, disease-specific survival (DSS) and disease-free survival were estimated using Kaplan-Meier actuarial methodology. The log-rank test was used to compare the differences between patients with and without metastatic TCC to PVLN. Cox multivariate regression analysis was used to determine whether the effect of metastatic PVLN on survival was independent of pathological stage.ResultsMetastatic TCC was found in the PVLN of 14 patients. Median followup and age were 13.5 months and 66.5 years, respectively. Patients with and without metastatic PVLN had similar characteristics and pathological disease staging. The overall survival, DSS and disease-free survival were significantly less for patients with metastatic TCC in PVLN (p = 0.002, p = 0.013 and p <0.001, respectively), and involvement of PVLN and pelvic nodes (p = 0.001, p = 0.010 and p = 0.041, respectively). Metastatic PVLN was an independent predictor of OS and DSS (p = 0.016 and p = 0.025, respectively).ConclusionsMetastases to PVLN appear to confer a significantly worse prognosis for patients undergoing radical cystectomy. Patients with identifiable metastatic PVLN may benefit from early adjuvant therapies.     

The prognostic impact of pelvic lymph node metastasis and lymphovascular invasion on bladder cancer

Objectives:   To present long-term results of a single-center series of patients undergoing bilateral pelvic lymphadenectomy and radical cystectomy for bladder cancer and to analyze the impact of pelvic lymph node metastasis and lymphovascular invasion on clinical outcome.
Methods:   Between 1986 and 2005 833 patients were treated with bilateral pelvic lymphadenectomy and radical cystectomy at our institution. 614 of them with valid clinical follow-up information and no neoadjuvant therapy could be evaluated.
Results:   Disease-free and overall survival in the entire cohort was 56.7% and 49.5% at 5 years and 52.4% and 38.2% at 10 years, respectively. 28.1% of all patients had pelvic lymph node metastasis. We found organ-confined tumor stages (≤pT2) in 43.8%. Patients with non-organ-confined tumor stages (≥pT3) and positive pelvic lymph nodes had a significantly shorter overall survival than those without lymph node metastasis ( P  < 0.0001). In the subgroup of ≤pT2, the presence of pelvic lymph node metastasis did not show a statistically significant effect on overall survival ( P  = 0.618). The presence of lymphovascular invasion was associated with an impaired survival ( P  < 0.0001). In multivariate analysis, pathological tumor stage ( P  < 0.0001), lymph node stage (≥pT3) ( P  = 0.004) and lymphovascular invasion ( P  = 0.001) were independent prognostic parameters.
Conclusions:   According to the present series, survival for patients with ≤pT2 does not depend on the lymph node stage. Lymphovascular invasion is an independent parameter of impaired survival and should be determined routinely in cystectomy specimens to identify patients, who may benefit from adjuvant systemic therapy.     

Prognostic implications of lymphangiogenesis in muscle-invasive transitional cell carcinoma of the bladder

OBJECTIVES: Aim of the study was to describe and evaluate the association of lymph vessel density with clinicopathological parameters and survival in patients with muscle-invasive transitional cell carcinoma (TCC) of the bladder. METHODS: The data on 108 patients with muscle-invasive bladder TCC, who underwent radical cystectomy, were reviewed retrospectively. Sections were analysed immunohistochemically for D2-40, a specific lymphatic endothelial cell (LEC) marker. Counts of lymph vessels were taken in intratumoural and peritumoural areas as well as in normal tissue. To detect proliferating LECs, we performed a double immunostaining for D2-40 and the proliferation marker Ki-67. RESULTS: Peritumoural vessels were observed in 105 (97.2%) sections and intratumoural vessels in 65 (60.2%). Higher intratumoural lymph vesseI density (LVD) correlated significantly with poor histological differentiation (p=0.01). Higher peritumoural LVD showed a significant association with the presence of lymph node metastasis (p=0.0004). However, LVDs had no statistically significant influence on survival. Intratumoural and peritumoural lymph vessels showed proliferating LECs in varying proportions in all examined samples. CONCLUSIONS: The present study is the first to suggest the existence of proliferating lymph vessels, and, therefore, of lymphangiogenesis in bladder TCC. To our knowledge, it is also the first to confirm a strong correlation of higher peritumoural LVD with the presence of lymph nodes in clinically localized invasive bladder TCC. These findings indicate that lymphangiogenesis may contribute to tumour dissemination and thus provide a potential target for bladder cancer therapy.     

膀胱移行细胞癌肿瘤血管生成的研究

为探讨肿瘤微血管与膀胱移行细胞癌浸润和转移的关系，应用免疫组织化学技术在６４例膀胱移行细胞癌组织中对第Ⅷ因子相关抗原进行表达，并计数肿瘤的微血管（ＭＶ）。结果发现，术后复发者ＭＶ数明显高于未复发者（Ｐ＜００１），浸润性癌的ＭＶ数明显高于浅表性癌（Ｐ＜００１），组织学Ⅲ级高于Ⅰ、Ⅱ级（Ｐ＜００５），伴淋巴结转移的ＭＶ数显著高于未转移者（Ｐ＜００５）。结果提示以ＭＶ为标记的肿瘤血管与膀胱移行细胞癌的分期、分级及预后密切相关，肿瘤的增长和转移有赖于肿瘤血管的生成。     

膀胱移行细胞癌VEGF表达及与血管形成定量的关系

为了探讨膀胱移行细胞癌中血管内皮生长因子（ＶＥＧＦ）表达及其与血管形成定量关系，应用免疫组织化学方法，对６２例原发性膀胱移行细胞癌及８例正常膀胱组织中ＶＥＧＦ进行检测，并对其在３０例浸润性膀胱癌组织中表达与血管形成定量关系进行了研究。结果发现正常膀胱组织均为阴性反应，膀胱癌组织中ＶＥＧＦ蛋白阳性表达率为５６％。低分化和浸润性癌中ＶＥＧＦ蛋白阳性表达率明显高于高分化和表浅性癌组（Ｐ＜００５），浸润性膀胱癌组织中血管形成定量与ＶＥＧＦ表达密切相关（Ｐ＜００１）。结果提示：ＶＥＧＦ表达对膀胱癌生物学行为有重要影响。ＶＥＧＦ是膀胱癌发生发展过程中一个主要血管生成因子，ＶＥＧＦ蛋白表达和血管形成定量有可能成为预测膀胱癌转移和预后的指标     

人结直肠癌VEGF-C的表达及与淋巴结转移之间的关系

目的 :探讨血管内皮生长因子C(VEGF C)在人结直肠癌中的表达及与肿瘤淋巴结转移之间的关系。方法 :选择 47例结直肠癌标本 ,应用免疫组织化学染色方法 ,检测VEGF C在人结直肠癌组织中的表达 ,同时对伴与不伴有淋巴结转移的结直肠癌VEGF C表达的差异进行统计学分析。结果 :VEGF C在结直肠癌组织中的阳性表达率为 44 .7%,其中有淋巴结转移的表达率为 6 0 .0 %,无淋巴结转移的表达率为 17.7%,二者差异有统计学意义 (P <0 .0 1)。结论 :结直肠癌可表达VEGF C ,并与肿瘤细胞淋巴转移有关。