新辅助化疗前后胃或肠肿瘤患者MVD、PCNA及VEGF的变化及预后的研究

目的 :探讨新辅助化疗前后同一胃或肠肿瘤患者微血管密度 (MVD)、增殖细胞核抗原 (PCNA)及血管内皮细胞因子 (VEGF)有否变化、变化后的情况及与预后的关系。方法 :选择确诊为胃或肠肿瘤患者 59例为观察组 ,其中胃癌 2 8例 ,大肠癌 31例 ,分别检测同一患者化疗前病理检查标本及经动脉新辅助化疗后手术切除标本中MVD、PCNA及VEGF的表达。同期设未行新辅助化疗的胃或肠肿瘤患者 50例为对照。结果 :新辅助化疗后同一患者MVD、PCNA有降低 ,P <0 .0 5 ,有显著性差异 ;而VEGF阳性表达仅有部分增加 ,P >0 .0 5 ,无显著性差异。新辅助化疗前VEGF与MVD、PCNA呈正相关 (r=0 .2 1 ,0 .1 9,P <0 .0 5)。新辅助化疗后VEGF与MVD、PCNA无相关性 (r=0 .31 ,0 .2 5 ,P >0 .0 5)。新辅助化疗后患者 3年内复发 1 3例 ,对照组 3年内复发 2 3例 ,两组病例统计学检验 ,P <0 .0 5,有显著性差异。复发者MVD、PCNA明显高于未复发者 ,P <0 .0 5 ,有显著性差异。对照组手术前后MVD、PCNA及VEGF无变化。结论 :新辅助化疗可以降低MVD及PCNA的表达。新辅助化疗后MVD、PCNA减少是降低肿瘤患者术后复发率的重要因素。同时提示新辅助化疗后单纯的VEGF表达对预后并无临床意义。经新辅助化疗后 ,MVD、PCNA变化不明显的患者预后不良。

Sdudying Expression of MVD、PCNA and VEGF in Stomach Cancer or Large Intestine Cancer Following New Supplementary Chemotherapy and Relationship Between MVD、PCNA and VEGF and Prognosis

Objective: To investigate whether or not changing and the situation of changing in MVD?PCNA and VEGF in the same patient of stomach cancer or large intesstine cancer following new supplementary chemotherapy and their relation with prognosis. Methods: The expression of MVD?PCNA and VEGF of the same patients sample including bath treatment and no treatment have been examined seperately around new supplementary chemotherapy treatment in 59 cases patients which contain 28 cases stomach cancer and 31 cases large intesstine cancer as observe group. While 50 cases without any treatment as contrast group. Results: There are remarked different expression of MVD and PCNA in the same patient of stomach cancer or large intestine cancer between treatment and no treatment. The statistics date are P<0.05, which is notable meaning. But there is merely a few raising expression of VEGF in the same patients of stomach cancer or large intestine cancer between treatment and no treatment. The statistics date is P>0.05, which is no notable meaning. Before new supplementary chemotherapy,there are positive interrelation betweet VEGF and MVD, PCNA in the same patient of stomach cancer or large intestine cancer, the r is 0.21 and 0.19 seperately,P<0.05. But there are no relatation betweet VEGF and MVD, PCNA in the same patients of stomach cancer or large intestine cancer following new supplementary chemotherapy,the r is 0.31 and 0.25 seperately,P>0.05. In the test group, 13 cases have recur during the three years. Meanwhile having 23 cases in constrast group. The statistics date is P<0.05, which is notable meaning.The reure with higher degree expression of MVD and PCNA.The statistics date is P<0.05, which is notable meaning. In the control group, the expression of MVD and PCNA have no changing in the same patient of stomach cancer or large intestine cancer between operation and prior to operation,there are no obvious difference with P>0.05. Conclusion: The expression of MVD and PCNA of the same patient of stomach cancer or large intestine cancer can be decreased throughout new supplementary chemotherapy.The reduce of reuming rate of malignant tumor is just relatoin to the reduction of MVD and PCNA degree.Meanwhile,after the new supplementary chemotherapy, the only VEGF expression has no clinical meaning for estimatment malignant tumor patients prognosis. Following new supplementary chemotherapy the patients who with less decreasing of MVD and PCNA will have a bad prognosis.