肝细胞癌血管生成与凋亡抑制蛋白bcl-2、bcl-xl的关系及临床意义

目的探讨肝细胞癌(hepatocellular carcinoma,HCC)组织中血管生成与凋亡抑制蛋白bcl-2和bcl-xl的关系及其临床意义.方法对经病理证实的肝细胞癌38例共40个癌灶进行分析,用免疫组化SP法检测癌组织中血管内皮生长因子(vascular endothelial growthfactor,VEGF)、bcl-和bcl-xl的表达以及微血管密度(microvssel density,MVD),分析它们之间的相互关系,并将免疫组化的结果与患者的临床及手术、病理结果进行对照分析.结果bcl-2与bcl-xl明显相关(P＜0.01),VEGF与bcl-2之间也存在一定的相关性(P＜0.05);在VEGF、bcl-xl的阴性和阳性表达组MVD均具有显著的差异(P＜0.05).在不同的病理分级和病灶大小之间,bcl-xl表达的阳性率均具有显著差异(P＜0.05);侵袭转移组、病理分级高以及无包膜/包膜欠完整的病灶的MVD明显高于无侵袭转移组、病理分级低以及包膜完整的病灶的MVD(P＜0.05);而VEGF阳性表达的病灶的包膜也倾向于无包膜/包膜欠完整(P＜0.05).结论VEGF和bcl-xl调控肿瘤的血管生成,凋亡抑制蛋白、VEGF和MVD共同影响HCC的临床病理特征.

The correlation of the apoptosis inhibitive proteins and angiogenesis in hapatocellular carcinoma and its clinical significance

Objective To explore the correlation of the angiogenesis and the apoptosis inhibitive proteins including bcl-2 and bcl-xl in hepatocellular carcinoma (HCC) and its clinical significance. Methods Thirty-eight cases (40 lesions) of HCC verified by histopathology were studied. The microvessel density (MVD) and the expressions of VEGF, bcl-2 and bcl-xl were detected with immunohistochemical SP method. The relationships among these immunohistochemical results were detected, and the clinical and histopathological characteristics of HCC were compared with those results. Results The correlations between bcl-2 and bcl-xl, VEGF and bcl-2 were found (P< 0.01,P< 0.05 respectively); The MVD was higher in the positive expression group of bcl-xl or VEGF than that in the negative expression ones (P< 0.05 respectively). The positive expression of bcl-xl changed obviously in different pathological grades and lesion diameters (P< 0.05); The MVD was higher in the groups with higher pathological grade, infiltration and severity (intrahepatic daughter foci, tumor-emboli in portal veins, lymphatic metastasis), or incomplete pseudocapsula/non-pseudocapsula than that in those groups with lower pathological grade, infiltration and severity, or complete pseudocapsula (P< 0.05), and the VEGF expression in incomplete pseudocapsula/non-pseudocapsula group was also higher than that in complete pseudocapsula ones (P< 0.05). Conclusion The angiogenesis in HCC may be regulated by the expressions of VEGF and bcl-xl, and histopathological characteristics are influenced by VEGF, MVD and the apoptosis inhibitive proteins together.