甲状腺乳头状癌VEGF—C表达、TAMs浸润与淋巴管生成的关系及临床意义

目的探讨甲状腺乳头状癌(PTC)中血管内皮生长因子-C(VEGF-C)的表达、肿瘤相关巨噬细胞(TAMs)浸润与淋巴管生成的关系及临床意义。方法采用免疫组化SP法检测72例PTC中VEGF-C、血管内皮生长因子-C受体3(VEGFR-3,标记淋巴管)、CD68(标记TAMs)的表达;在显微镜下计数淋巴管密度(LVD)、TAMs;采用免疫组化双染LAB-SA法观察TAMs中VEGF-C的表达。结果VEGF-C阳性指数(PI)值腺外型(21.4±2.8)高于微癌(10.1±0.8)与腺内型(11.9±1.2)(P均<0.05),有淋巴结转移(23.2±3.8)显著高于无淋巴转移(14.5±2.9)(P<0.01);TAMs计数腺外型(43.2±5.6)高于微癌(18.8±1.9)与腺内型(23.0±2.0)(P均<0.01),有淋巴结转移(41.3±8.4)显著高于无淋巴转移(30.4±4.8)(P<0.01);LVD腺内型(9.9±1.8)高于微癌(6.0±0.8)、腺外型(19.2±3.0)高于腺内型(P均<0.05),有淋巴结转移(19.6±2.5)高于无淋巴转移(12.5±2.8)(P<0.05)。VEGF-C与LVD计数呈正相关(r=0.91,P<0.01),TAMs与LVD呈正相关(r=0.83,P<0.01)。VEGF-C阳性表达的巨噬细胞占总巨噬细胞的21.3%。结论VEGF-C、TAMs及淋巴管生成与PTC的侵袭及淋巴结转移有关;VEGF-C、TAMs参与了淋巴管生成。

Relationship in expression of VEGF-C,tumor associated macrophages infiltration, lymphangiogenesis and clinical significance in papillary thyroid carcinoma

Objective To investigate the relationships in expression of VEGF-C,tumor associated macrophages （TAMs） infiltration, ]ymphangiogenesis and clinical significance in papillary thyroid eareinoma （PTC）. Methods Expression of VEGF-C, CD68 （ marking TAMs） and VEGFR-3 （ marking lymphatic） was determined by immunohistoehemical SP method in 72 cases with PTC. Double staining immunohistochemistry （ LAB SA method） was applied to observe the expression of VEGFc in TAMs. Results The VEGF-C PI in EPC type （ 21.4 ± 2.8 ） was obviously higher than that of PMC type （ 10.1 ± 0.8） and IPC type （ 11.9 ±1.2） （ P 〈 0.05 ）, and it was obviously higher in patients with lymph node metastasis （23.2 ± 3.8 ） than that of without metastasis （ 14.5 ± 2.9, P 〈 0.01 ）. The TAMs count in EPC type （43.2 ± 5.6） was obviously higher than that of PMC type （18.8 ± 1.9） and IPC type （23.0 ± 2.0） （ P 〈 0.01 ）, and it was higher in patients with lymph node metastasis（41.3 ± 8.4）than that of without metastasis （ 30.4± 4.8 ） （ P 〈 0.01 ）. Additionally, the LVD was （6.0 ± 0.8 ）, （9.9 ± 1.8 ） and （ 19.2 ± 3.0） in PMC, iPC and EPC type, respectively, and it had significant differences among groups （ P 〈 0.05）. The LVD in patients with lymph node metastasis（ 19.6 ± 2.5） was higher than that of without metastasis（ 12.5 ±2.8） （ P 〈 0.05）. There was positive correlation between VEGF-C and LVD（ r = 0.91, P 〈 0.01 ）, TAMs and LVD （ r = 0.83, P 〈 0.01 ）. Macrophage with positive VEGF-C expression aceounted for 21.3%. Conclusion It demonstrated that VEGF-C, TAMs and lymphangiogenesis were related to invasion and metastasis of PTC, furthermore, it showed that VEGF-C and TAMs played important roles in lymphangiogenesis.