VEGF-C、VEGF-D信号通路与肿瘤的淋巴管生成

肿瘤的区域(前哨)淋巴结转移是肿瘤远处播散的第一步,并且可以看做是肿瘤预后的一个重要标志.新近的研究表明,肿瘤的淋巴管生成和淋巴结转移密切相关.肿瘤细胞转移至前哨淋巴结后,可以继续促进淋巴管的生成,从而进一步促进肿瘤细胞的远处转移.血管内皮生长因子-C(VEGF-C)和血管内皮生长因子-D(VEGF-D)是首先发现的特异性淋巴管生成因子,许多临床试验表明,VEGF-C和VEGF-D的表达与肿瘤的淋巴转移密切相关.目前又发现了与淋巴管生成有关的其他细胞因子,如VEGF-A.最为重要的是,采用特异性抗体、可溶性受体结构或小的膜激酶抑制剂阻断细胞因子作用的信号途径,可以有效地阻止肿瘤淋巴管的生成,这也为肿瘤的治疗提供了一个新的途径.     

VEGF-C、VEGF-D信号通路与肿瘤的淋巴管生成

肿瘤的区域(前哨)淋巴结转移是肿瘤远处播散的第一步,并且可以看做是肿瘤预后的一个重要标志.新近的研究表明,肿瘤的淋巴管生成和淋巴结转移密切相关.肿瘤细胞转移至前哨淋巴结后,可以继续促进淋巴管的生成,从而进一步促进肿瘤细胞的远处转移.血管内皮生长因子-C(VEGF-C)和血管内皮生长因子-D(VEGF-D)是首先发现的特异性淋巴管生成因子,许多临床试验表明,VEGF-C和VEGF-D的表达与肿瘤的淋巴转移密切相关.目前又发现了与淋巴管生成有关的其他细胞因子,如VEGF-A.最为重要的是,采用特异性抗体、可溶性受体结构或小的膜激酶抑制剂阻断细胞因子作用的信号途径,可以有效地阻止肿瘤淋巴管的生成,这也为肿瘤的治疗提供了一个新的途径.     

胃癌淋巴管生成与淋巴管密度的相关性研究

胃癌的发病率日益增加,而淋巴转移是导致患者最终死亡的重要原因之一.血管内皮生长因子C(VEGF-C)、血管内皮生长因子D(VEGF-D)与其特异性的受体血管内皮生长因子受体3(VEGFR-3)结合能够促进淋巴管生成,并促进淋巴管转移,并且与肿瘤的淋巴管密度密切相关.近年来对于胃癌的淋巴管的研究正在开展,本文就胃癌淋巴管生成机制、淋巴管生成与淋巴管密度关系的最新研究进展以及此项研究的临床意义加以综述.     

淋巴管生成因子与消化道肿瘤

目的 介绍VEGF-C和VEGF-D在淋巴管生成及消化道肿瘤淋巴转移中的作用的有关研究进展。方法对近年来VEGF-C和VEGF-D的结构功能特点、及其在淋巴管生成和消化道肿瘤淋巴转移中的作用的研究进展进行综述和分析。结果VEGF-C和VEGF-D可促进血管、淋巴管生成和淋巴转移。胃癌中VEGF-CmRNA及其蛋白表达与淋巴侵犯、静脉侵犯、淋巴结转移及低的5年生存率相关；VEGF-C在食管癌和结直肠癌中的作用以及VEGF-D在结直肠癌中的作用有待进一步研究。结论VEGF-C、VEGF-D／VEGFR-3信号通路可能成为控制肿瘤生长转移的理想靶点，抗新生淋巴管治疗有望成为肿瘤生物治疗新模式。     

VEGF-C和VEGF-D蛋白表达在胰腺癌淋巴转移中的意义

目的探讨胰腺癌中VEGF-C、VEGF-D蛋白表达与淋巴结转移之间的相关关系,阐明癌周淋巴管增生在胰腺癌淋巴转移中的作用及意义。方法免疫组化检测30例胰腺癌组织中VEGF-C、VEGF-D的表达及其与临床病理、淋巴结转移的关系。结果胰腺癌VEGF-C、VEGF-D蛋白表达阳性率分别为73%(22/30)、57%(17/30),肿瘤周边部位显著高于肿瘤中心部位,其表达与肿瘤的部位、分化程度、组织学类型无关,与肿瘤的TNM分期有关,Ⅲ~Ⅳ期显著高于Ⅰ~Ⅱ期。在VEGF-C、VEGF-D蛋白阳性组,淋巴结转移均显著增多。结论VEGF-C和VEGF-D与诱导胰腺癌淋巴管生成,促进肿瘤细胞淋巴道转移有关。     

胃癌淋巴管生成与淋巴结转移的关系

目的:研究胃癌淋巴管生成与淋巴结转移的关系。方法:应用逆转录-聚合酶链反应(RT-PCR)和免疫细胞化学方法检测血管内皮生长因子-C(VEGF-C)和血管内皮生长因子受体-3(VEGFR-3)mRNA及其蛋白在5株胃癌细胞株和3对伴有淋巴结转移的胃癌组织及相应的正常黏膜中的表达。此外,还应用免疫组织化学方法检测86例胃癌标本的淋巴管密度(LVD)和VEGF-C蛋白的表达。结果:VEGF-C mRNA和蛋白高表达于3株胃癌细胞,而VEGFR-3 mRNA和蛋白在上述3个细胞株中均呈弱表达。VEGF-C和VEGFR-3 mRNA均表达于3对伴有淋巴结转移的胃癌和相应的正常黏膜组织中,但在正常组织中的表达水平低于肿瘤组织。VEGF-C蛋白在66.3%(57/86)的病例中呈阳性表达。在伴淋巴结转移的胃癌中,VEGF-C表达较无淋巴结转移者更显著(P<0.001),其表达与淋巴管浸润(P<0.001)和TNM分期(P<0.01)均密切相关,但与病人的年龄和性别、肿瘤大小、位置、组织学类型、浸润深度及远处转移均无明显相关。LVD则与VEGF-C蛋白表达(P<0.001)、淋巴结转移(P<0.01)、淋巴管浸润(P<0.01)、TNM分期(P<0.05)及组织学类型(P<0.05)密切相关,但与病人的年龄和性别、肿瘤大小、位置、浸润深度及远处转移无明显相关。结论:在胃癌中,VEGF-C可能通过VEGFR-3信号通道促进淋巴管生成,从而增加胃癌淋巴结转移率。因此,肿瘤淋巴管生成可能成为治疗胃癌的一个新靶点。     

淋巴生成因子C和淋巴生成因子D在颅内恶性肿瘤中的表达

血管内皮生长因子(VEGF)-C和VEGF-D是VEGF家族新成员,被称为淋巴管生成因子,具有促进肿瘤细胞经淋巴途径转移的作用[1].为探讨颅外肿瘤通过淋巴途径向颅内的可能性,我们观察脑转移癌、星形细胞瘤、髓母细胞瘤中VEGF-C、VEGF-D的蛋白表达.     

S100A4和血管内皮生长因子C、D在胃癌组织中的表达及其与淋巴结转移和预后的关系

目的 观察人胃癌S100A4和血管内皮生长因子(VEGF)-C、VEGF-D的表达,探讨其与临床病理特征及预后的关系.方法 应用免疫组织化学方法检测108例人胃癌及20例癌旁组织中S100A4和VEGF-C、VEGF-D的表达.分析S100A4和VEGF-C、VEGF-D表达与患者年龄、性别、肿瘤大小、病理类型、浸润深度、淋巴结转移和肿瘤TNM分期的关系,并作预后分析.结果 S100A4和VEGF-C、VEGF-D在胃癌组织中的阳性率明显高于癌旁组织(P＜0.05).S100A4的表达与肿瘤大小和淋巴结转移有关(P＜0.05),VEGF-C的表达与淋巴结转移和TNM分期有关(P＜0.05),VEGF-D的表达与淋巴结转移和TNM分期无明显相关(P＞0.05),肿瘤组织内S100A4和VEGF-C两者表达呈正相关(P＜0.05).S100A4和VEGF-C、VEGF-D阳性胃癌患者5年生存率分别低于阴性患者,差异无统计学意义(P＞0.05).结论 S100A4和VEGF-C的表达与胃癌的淋巴结转移有关,S100A4可能参与VEGF-C淋巴管生成通路,在胃癌的淋巴结转移中发挥重要作用.     

胰腺癌淋巴管生成与血管内皮生长因子C的关系

目的探讨人胰腺癌组织中血管内皮生长因子C（VEGF-C）和其受体3（VEGFR-3）的表达与胰腺癌微淋巴管密度（LVD）、区域淋巴结转移的关系。方法免疫组织化学SP法检测67例人胰腺癌组织VEGF-C的表达情况，VEGFR-3结合Ⅳ型胶原（collagen type Ⅳ）进行LVD计数并结合临床和病理资料进行分析。结果VEGF-C的表达和胰腺癌分化程度、区域淋巴结转移、远处转移均呈显著相关（P〈0．05），LVD与胰腺癌分化程度、区域淋巴结转移、VEGF-C的表达程度呈明显相关（P〈0．01）。VEGFR-3不仅在肿瘤淋巴管内皮细胞上表达还在部分肿瘤血管内皮细胞上表达。结论VEGF-C通过其受体VEGFR-3促进胰腺癌淋巴管生成、区域淋巴结转移。     

VEGF-C及其受体与胃癌淋巴转移关系的研究进展

目的介绍血管内皮生长因子C（VEGF-C）及受体在淋巴管形成过程中的作用机理及其与胃癌淋巴转移关系研究的最新进展。方法通过复习国内、外文献,对VEGF-C及其受体在胃癌组织中的表达、在胃癌淋巴结转移中的作用及其在胃癌治疗上的应用前景进行综述和分析。结果 VEGF-C及其受体与胃癌淋巴管形成及淋巴转移关系密切,VEGF-C高表达可认为是淋巴结转移的早期事件,并可作为预测发生淋巴结微转移的独立因素。通过抑制胃癌细胞分泌VEGF-C或阻断VEGF-C与受体VEGFR-3结合,可以抑制胃癌新生淋巴管形成、癌细胞浸润及远处播散,从而降低死亡率,改善患者预后。结论 VEGF-C及其受体能促进了胃癌淋巴管生成及淋巴转移,针对VEGF-C及其受体的治疗方法有望成为胃癌治疗的一个新手段。     

血管内皮生长因子C和D在胃癌组织和血清中的表达和意义

目的 探讨VEGF-C和VEGF-D在胃癌组织和血清中的表达及其与淋巴结转移的关系.方法 2005年1月至12月80例胃癌手术患者,48例有区域淋巴结转移,32例无区域淋巴结转移,另设10例胃溃疡患者的正常胃黏膜为对照.ELISA法检测血清VEGF-C和VEGF-D,应用免疫组织化学方法检测正常胃黏膜和胃癌标本VEGF-C、VEGF-D表达情况.结果 胃癌患者血清VEGF-C和VEGF-D明显高于胃溃疡患者(χ2=8.39,P<0.05).胃癌患者血清VEGF-C阳性率受淋巴结转移影响(χ2=7.01,P<0.05).胃癌组织中,VEGF-C、VEGF-D阳性表达率分别为53%(42/80)、63%(50/80),明显高于正常胃黏膜组织(χ2=6.44.6.58,P<0.05),VEGF-C阳性表达率受淋巴结转移影响(χ2=11.25,P<0.05).结论 VEGF-C的表达受胃癌淋巴结转移影响,血清VEGF-C可作为胃癌的标志物,对术前判定淋巴结转移具有一定的临床价值.     

Vascular Endothelial Growth Factor C Promotes Lymph Node Metastasis in a Rectal Cancer Orthotopic Model

Purpose Vascular endothelial growth factor C (VEGF-C), a novel member of the vascular endothelial growth factor family, is a relatively specific lymphangiogenic growth factor. It has been suggested that increased expression of VEGF-C in primary tumors is correlated with lymph node metastasis. We conducted this study to determine whether VEGF-C directly affects lymphangiogenesis and lymph node metastasis in colorectal cancer.Methods For an accurate analysis and clear visualization of metastases, the rectal cancer cell line, DLD1, was engineered to stably express green fluorescent protein (GFP) (DLD1/GFP). We implanted DLD1/GFP cells overexpressing VEGF-C orthotopically into the rectal walls of nude mice.Results Lymph node metastasis was confirmed in all (100%) of the mice bearing DLD1/GFP-VEGF-C tumors, but in only 25% of the mice bearing control tumors. There were more lymph node metastases per mouse in the mice bearing DLD1/GFP-VEGF-C tumors than in the mice bearing control tumors. There were no differences in cell growth and motility in vitro or in the resulting tumor volume from the implanted cells between the two groups. Immunohistochemical staining revealed that VEGF-C induced the growth of lymphatic vessels, which were enlarged in the tumor periphery and contained tumor cell emboli.Conclusion These results suggest that VEGF-C-induced lymphangiogenesis mediates tumor spread and the formation of lymph node metastasis.     

重组人内皮抑素对裸鼠结肠癌移植瘤淋巴管生成及淋巴结转移的抑制作用

目的 观察重组人内皮抑素(恩度)对裸鼠结肠癌移植瘤淋巴管形成及淋巴结转移的影响.方法 将人结肠癌SW620细胞株接种于BALB/C-nu雄性裸鼠,建立动物模型.实验分为对照组(生理盐水组)和恩度组.结果 (1)恩度组和对照组淋巴结转移率分别为10%(1/10)和80%(8/10)(P<0.01).(2)恩度组肿瘤淋巴管密度(7.17±0.75)明显低于对照组(14.83±0.98)(P<0.05).(3)恩度在体内和体外均抑制肿瘤细胞血管内皮生长因子(VEGF)-C和VEGF-D的表达.结论 重组人内皮抑素通过降低结肠癌移植瘤VEGF-C,-D的表达而抑制淋巴管的生成,降低肿瘤向淋巴结的转移几率.     

Lymphatic vessel density, microvessel density and lymphangiogenic growth factor expression in colorectal cancer

OBJECTIVE: Microvessel density (MVD) has been studied as a prognostic marker in human cancers. Quantification of lymphatic vessel density (LVD) is now possible by using new antibodies. Expression of the lymphangiogenic growth factors, VEGF-C and VEGF-D, is associated with poorer clinicopathological outcomes in various tumours. The aim of this study was to quantify LVD and MVD in colorectal cancer, determine the relationship between LVD, MVD and clinicopathological variables and examine the relationship between LVD and tumour expression of VEGF-C and VEGF-D. METHOD: Thirty primary colorectal cancers were immunostained for CD34, lymph vessel endothelial hyaluronan receptor-1 (LYVE-1), VEGF-A and VEGF-D using standard techniques. LVD and MVD were determined by Chalkley grid counting. Tumours were assessed for the presence or absence of LYVE-1 positive lymphatics at different areas within the tumour and the tumour was scored for VEGF-C and VEGF-D immunostaining intensity at the invading tumour edge. Non-parametric tests were used for statistical analysis and a P-value of <0.05 was taken as significant. RESULTS: Lymph vessel endothelial hyaluronan receptor-1 was an excellent lymphatic vessel marker. Within normal bowel wall, lymphatic vessels were found rarely in the superficial colonic mucosa, but were numerous in the submucosa and muscularis propria. In the majority of tumours, lymphatic vessels were located in the peri-tumoural area, intra-tumoural vessels were sparse and tended to be narrow with closed lumina. At the invading tumour edge, VEGF-C expression was higher (P = 0.028) and VEGF-D expression lower (P = 0.011), in tumours in which lymphatic vessels were present. No significant differences between LVD and any clinicopathological variable or route of metastasis were identified. CONCLUSION: Lymphatic vessel density and MVD can be quantified in colorectal carcinoma using immunohistochemical techniques. The balance between expression of VEGF-C and VEGF-D at the invading tumour edge may enhance lymphatic metastasis, by promoting tumour lymphangiogenesis or by activation of pre-existing lymphatic vessels. No relationship was identified between LVD and clinicopathological variables.     

Expression of vascular endothelial growth factor C (VEGF-C) and VEGF receptor-3 in human prostate cancer is associated with regional lymph node metastasis

BACKGROUND: Vascular endothelial growth factor C (VEGF-C) and its receptor, VEGFR-3, have been implicated as important factors in the formation of lymphatic vessels and recent evidence suggests that tumor lymphangiogenesis promotes lymphatic metastasis. METHODS: The expression of VEGF-C and VEGFR-3 was examined in 22 human prostate cancer specimens with immunohistochemistry. A semi-quantitative scoring system was used for evaluation of staining. RESULTS: Expression of VEGF-C was stronger in prostate cancer areas in comparison to adjacent benign glands. In addition, patients with lymph node metastases had a significantly higher expression of VEGF-C than patients without lymph node metastases. Interestingly, VEGFR-3 was expressed in malignant prostate epithelial cells and its expression was significantly higher in the lymph node positive group compared to the lymph node negative group. CONCLUSIONS: The results of the present study indicate that increased expression of VEGF-C and VEGFR-3 play a role in prostate cancer progression and in metastasis to regional lymph nodes.