中期因子与口腔鳞癌血管新生及预后的关系

目的:探讨中期因子(Midkine,MK)与口腔鳞癌(oral squamous cell carcinoma,OSCC)临床病理及其预后的关系,并研究其与微血管密度(microvessel density,MVD)的相关性.方法:应用免疫组化SP法检测63例OSCC中MK的表达;用CD34标记肿瘤血管内皮细胞计数肿瘤MVD,并对所有病例进行随访.结果:MK在OSCC组织中的表达显著高于正常口腔黏膜组织(P＜0.05);MK的表达与颈淋巴结转移存在相关性(P＜0.05),而与病人的性别、年龄及病理分化程度无关(P＞0.05);MK表达阳性组的MVD高于MK表达阴性组(P＜0.05);MK的表达与MVD呈正相关(P＜0.05).生存分析显示MK阴性组的5年生存率高于MK阳性组.术后复发组和无复发组的MK表达阳性率间无明显差异(P＞0.05).结论:MK的表达是OSCC的不良预后因子,OSCC中MK的高表达与血管生成密切相关,研究MK与肿瘤血管形成的关系可为抗血管生成治疗提供理论依据.

Study on the Expression of Midkine in Oral Squamous Cell Carcinoma

Objective: To investigate the expression of Midkine(MK) in oral squamous cell carcinoma(OSCC),and the correlations among their expression to the clinicopathologic characteristics and microvessel density(MVD) of the OSCC.Methods: S-P immunohistochemical method was used to quantify the expression level of MK in pathology sections of 63 OSCC specimens.In all cases of OSCC,microvessel density was evaluated by counting any CD34-reactive endothelial cell or endothelial-cell cluster.The patients with OSCC were followed up from 1987 to 2001.The relationships between the expression of MK,MVD,the clinicopathologic characteristics and postoperative survival time were statistically analysed.Results: The expression of MK in OSCC was far more than those in normal oral mucosa(P<0.05).The expression of MK was significantly associated with the cervical lymph node metastasis(P<0.05),but not associated with sex,age and the degree of pathological differentiation(P>0.05).MVD of the MK-positive group was higher than the MK-negative group(P<0.05).The expression of MK and the MVD in OSCC is of obvious positive relativity(P<0.05).Survival analysis showed that the postoperative 5-year survival of patients with negative MK expression was significantly higher than those with positive MK expression.The positive expression rate of MK between the postoperative recurrence group and the group never recurrent had no such difference(P>0.05).Conclusion: The expression of MK was closely correlated with tumor development,progression and prognosis in OSCC.It was a poor prognostic factor and may serve as a valuable tumor marker and a prognostic indicator.MK may work on the neovascularization of OSCC.Study on the correlation of MK and the neovascularization of OSCC may provide theory evidence for antiangiogenic therapy of OSCC.