血管内皮生长因子对骨肉瘤的血管生成及转移预后的影响

背景血管内皮生长因子(VEGF)是肿瘤血管再生的重要刺激因子,肿瘤血管再生与众多肿瘤患者预后密切相关.骨肉瘤血管生成与预后的关系如何?目的研究VEGF对骨肉瘤血管生成、生长、转移及预后的影响.设计随机对照的实验研究.地点和对象实验地点唐都医院全军骨肿瘤研究所.对象69例骨肉瘤标本.干预对69例骨肉瘤患者的临床病理资料进行回顾性研究,应用CD34,VEGF单克隆抗体对其组织切片分别进行免疫组化染色,应用地高辛标记的VEGF探针对27例原发性骨肉瘤进行原位杂交染色.分析研究VEGF表达和CD34染色阳性血管密度与患者预后关系.主要观察指标血管内皮生长因子(VEGF)和微血管密度(MVD).结果VEGF阳性表达率为56.5%(39/69),VEGF阳性组肿瘤微血管计数(MVC)(35.7±9.8)及微血管周径(MVP)(2.76±0.18)μm明显高于VEGF阴性组[MVC(7.2±2.4)及MVP(0.62±0.04)μm].多元回归分析显示,血管密度增高及VEGF表达阳性与骨肉瘤患者的远隔转移发生、不良预后密切相关(P＜0.05).临床病理资料中,外科手术边界微小病灶阳性情况、Enneking外科分期、肿瘤大小和患者年龄与患者预后相关(P＜0.05).患者性别、手术方法分类以及病理亚型与预后无相关性.结论VEGF在骨肉瘤的血管生成和转移中起到重要作用,VEGF是骨肉瘤血管生成的决定性刺激因子,骨肉瘤MVD和骨肉瘤组织中VEGF表达情况是骨肉瘤患者的独立性预后因素.

Effects of vascular endothelial growth factor expression on angiogenesis,tumor growth and metastasis in osteosarcoma

BACKGROUND: Vascular endothelial growth factor(VEGF) is considered as the most important stimulating factor in angiogenesis of tumor, which is correlated with the prognosis of numerous tumor patients. However, its correlation with osteosarcoma has not been demonstrated.OBJECTIVE: To investigate the effects of VEGF on angiogenesis, growth,netastasis and prognosis in osteosarcoma.DESIGN: A randomized controlled trial study was conducted.SETTING and PARTICIPANTS: The experiment was completed in Institute of Orthopaedic Oncology of Chinese PLA, Tangdu Hospital, Fourth Military Medical University. Subjects were 69 specimens of osteosarcoma.INTERVENTIONS: A retrospective study was undertaken on the clinical pathological data of 69 patients with osteosarcoma. Immunohistochemical staining was performed on the tissue sections by CD34 and VEGF monoclonal antibody, while hybridization in situ staining was performed on 27cases of original osteosarcoma by VEGF probe, which was tagged by cardiox. The correlation between the expression of VEGF and the density of CD34-positive microvessels, the prognostic significance of VEGF expression,microvascular density(MVD) and clinicopathological variables were analyzed.