血管内皮生长因子-C、D对大肠癌的预后判断价值

目的观察血管内皮生长因子(VEGF)-C和VEGF-D在大肠癌中的表达,探讨其在大肠癌预后判断中的价值。方法抽取1996年1月至1998年1月于我院行大肠癌根治术且接受正规随访的大肠癌病例69例;采用EnVision免疫组织化学技术检测VEGF-C和VEGF-D在69例大肠癌及20例正常大肠组织的表达;采用抗CD34免疫组织化学技术评价大肠癌微血管密度(MVD);采用Axioplan 2 imaging显微图像分析系统对免疫组织化学染色结果进行定量分析。结果69例患者平均随访(68.96±32.79)个月,中位随访87个月,108个月无病生存率与总生存率分别为51.44%和60.07%。大肠癌VEGF-C和VEGF-D表达显著高于相应正常大肠组织(P<0.01);VEGF-C表达与大肠癌淋巴结转移及临床分期显著相关(P<0.05);VEGF-D表达与大肠癌患者年龄(≤68;>68岁)、淋巴结转移及肿瘤浸润深度显著相关(P<0.05)。VEGF-C和VEGF-D表达与大肠癌MVD显著相关(P<0.05);VEGF-C和/或VEGF-D高表达的大肠癌患者组总生存期和无病生存期均显著低于VEGF-C和/或VEGF-D低表达患者组(P<0.05)。结论VEGF-C和VEGF-D在大肠癌中异常高表达,且与大肠癌淋巴结转移、临床分期、无病生存与总生存率显著相关,可作为临床大肠癌预后判断标志物。

Value of VEGF-C and VEGF-D in predicting the prognosis of colorectal carcinoma

Objective To evaluate the value of vascular endothelial factor (VEGF)-C and -D in predicting the prognosis of coloreetal carcinoma (CRC).Methods Between Jan.1996 and Jan.1998,in 69 patients with pathologically confirmed CRC who received radical surgery and routine follow-up and 20 cases of normal colorectal tissues,the expression of VEGF-C and VEGF-D protein in relation to microves- sel density (MVD) was examined by immunohistochemistry.Results All the 69 patients were followed up and the disease-free survival (DFS) and the overall survival (OS) at 108 months were 51.44% and 60.07% respectively.The VEGF-C expression level was significantly correlated with the lymphatic inva- sion (P<0.05) and clinical stage of CRC (P<0.01).The expression of VEGF-D protein was signifi- cantly correlated with the patients'age (P<0.05),depth of tumor invasion (P<0.05 ),and lymphatic invasion (P<0.05).The VEGF-C and VEGF-D expression was significantly correlated with MVD and both the OS1 and DFS were significantly shorter in patients with higher VEGF-C and/or VEGF-D expres- sion level.Conclusion Higher expression of VEGF-C and VEGF-D which was closely correlated with lymphatic involvement and poorer prognosis might be used as prognosis indicators for CRC.