胰腺癌组织中血管内皮生长因子和尿激酶型血纤维蛋白溶菌酶原活化剂基因表达与血管生成的关系及临床意义

目的探讨胰腺癌组织中血管内皮生长因子(VEGF)和尿激酶型血纤维蛋白溶菌酶原活化剂(uPA)表达与血管生成的关系及其临床意义。方法采用免疫组织化学法检测30例胰腺癌组织及6例正常胰腺组织中VEGF和uPA表达情况,分析其与肿瘤组织微血管密度(MVD)的关系。结果胰腺癌组织中VEGF和uPA的阳性表达率分别为53.3%和63.3%。胰腺癌中的MVD明显高于正常组织(P=0.017)。VEGF和uPA表达与MVD有关(P<0.05)。MVD在Ⅰ、Ⅱ期和Ⅲ期胰腺癌组间表达差异有统计学意义(F=4.297,P=0.047),VEGF表达与肿瘤有无淋巴结转移有关(2=4.852,P=0.028)。VEGF在Ⅰ、Ⅱ、Ⅲ期胰腺癌肿瘤组织中表达差异有统计学意义(2=6.914,P=0.032)。uPA在肿瘤大小中的表达差异有统计学意义(2=410.435,P=0.001)。MVD与生存期之间存在负相关(r=0.472,P=0.017)。组织分化程度是影响胰腺癌生存期的危险因素。结论血管生成在胰腺癌的发生、发展过程中起重要作用,VEGF和uPA在胰腺癌组织中过度表达可为肿瘤细胞的浸润创造条件。抗血管生成治疗可能有助于提高胰腺癌的治疗效果。

Correlation of VEGF and uPA expression to angiogenesis in pancreatic carcinoma and its clinical signifinance

Objective To investigate the relationship of the expression of vascular endothelial growth factor（ VEGF） and urokinase-type plasminogen activator（ uPA） and with angiogenesis in pancreatic carcinoma.Methods Using immunohistochemical staning,the expression of VEGF,uPA and microvascular density was examined in 30 cases of pancreatic carcinoma and 6 cases of normal pancreatic tissue（ control）.Results The expression of VEGF,uPA was found in 53.3% and 63.3% of cases.MVD of pancreatic cancer is significantly higher than that of normal tissue（ P = 0.017）.The expression of VEGF was correlated with lymphatic metastasis and stage of pancreatic tumor.uPA expression has a statistically significant difference inthe size of tumor（ P = 0.001）.There was a negative correlation between MVD and survival（ r =-0.371,P = 0.011）.Multivariate regression analysis showed that histodifferentiation is a risk factor.Conclusions Angiogenesis plays a role in the growth,progression,invasion and metastasis.VEGF and uPA may creat an environment that enables pancreatic cancer cells to invade surrounding tissues.Antiangiogenic therapy may improve the effect for pancreatic cancer after surgery.