血管内皮生长因子C和微淋巴管密度与胆管癌淋巴结转移及预后的关系

目的:探讨胆管癌组织中血管内皮生长因子C(VEGF-C)的表达及微淋巴管密度(MLVD)与胆管癌临床病理特征及预后的关系。方法:应用免疫组化法分别检测47例胆管癌、40例近癌的非癌胆管及15例正常肝外胆管组织中VEGF-C的表达和D2-40标记的MLVD。分析两者间的相关性,及其与临床病理特征和预后的关系。结果:胆管癌组织中VEGF-C的阳性表达率明显高于近癌的非癌胆管和正常胆管组织(均P<0.05),胆管癌和近癌的非癌胆管组织中MLVD明显高于正常胆管组织(均P<0.05);VEGF-C的表达以及MLVD与胆管癌浸润深度、TNM分期、淋巴结转移密切相关(P<0.05),且MLVD还与胆管癌分化程度有关(P<0.05);VEGF-C阳性胆管癌组织MLVD明显大于其阴性胆管癌组织(P<0.05),且VEFG-C表达与MLVD呈正相关(r=0.615,P<0.05);VEFG-C阴性表达患者预后明显优于其阳性表达患者,复发者胆管癌组织中的MLVD明显高于无复发者(P<0.05),且MLVD与患者生存期呈负相关(r=-0.542,P<0.05)。结论:VEGF-C的表达和MLVD与管癌淋巴结转移、预后密切相关,VEGF-C可能是预测胆管癌淋巴结转移的有效指标之一。

Relations of VEGF-C and micro-lymphatic vessel density with lymphatic metastasis and prognosis of cholangiocarcinoma

Objective: To investigate the relations of vascular endothelial growth factor C (VEGF-C) expression and micro-lymphatic vessel density (MLVD) in cholangiocarcinoma tissues with the clinicopathologic features and prognosis of cholangiocarcinoma. Methods: The VEGF-C expression and D2-40 positive MLVD in 47 cases of cholangiocarcinoma tissues, 40 cases of adjacent non-tumor biliary tissues and 15 cases of normal biliary tissues were detected by immunohistochemical staining. The correlation between VEGF-C and their relations with clinicopathological characteristics and prognosis were analyzed. Results: The positive expression rate of VEGF-C in cholangiocarcinoma tissues was significantly higher than those in adjacent non-tumor and normal biliary tissues (both P<0.05), and the MLVD in both cholangiocarcinoma and adjacent non-tumor biliary tissues were significantly higher than that in normal biliary tissues (both P<0.05). The VEGF-C expression and MLVD were closely related to the depth of invasion, TNM stage and lymphatic metastasis of cholangiocarcinoma (all P<0.05), moreover, MLVD was also relevant to the differentiation degree of cholangiocarcinoma (P<0.05). MLVD in the VEGF-C positive cholangiocarcinoma tissues was significantly higher than that of the negative ones (P<0.05), and the VEGF-C expression was positively correlated with MLVD (r=0.615, P<0.05). The patients with negative VEGF-C expression had better prognosis than those with positive VEGF-C expression (P<0.05), and MLVD in the cholangiocarcinoma tissues of the recurrent cases was significantly higher than that of the non-recurrent ones (P<0.05); further, MLVD showed a negative correlation with the survival time of the patients (r=–0.542, P<0.05). Conclusion: VEGF-C expression and MLVD are closely related to the lymphatic metastasis and prognosis of cholangiocarcinoma. VEGF-C may potentially become one of the effective indicators for predicting lymphatic metastasis in patients with cholangiocarcinoma.