血管内皮生长因子受体2和血管内皮生长因子受体3的表达与肾乳头状癌生物学行为密切相关

目的 探讨血管内皮生长因子受体(VEGFR)在肾乳头状癌中的表达及与生物学行为的关系.方法 采用组织芯片及免疫组化SP法检测82例肾乳头状癌组织中VEGFR和增殖细胞核抗原(PCNA)的表达水平.结果 肾乳头状癌中VEGFR-1、VEGFR-2和VEGFR-3阳性率分别为82.9%(68/82)、63.4%(52/82)和34.1%(28/82),PCNA的阳性率为67.1%(55/82).VEGFR-1的表达与肾乳头状癌的临床病理因素无关.VEGFR-2的表达与肿瘤大小(P=O.016)、组织学分级(P=0.034)和远处转移(P=0.002)有关,而与患者性别、年龄、肿瘤部位、临床分期以及淋巴结转移状态无关.VEGFR-3的表达与肿瘤组织学分级(P=0.028)、淋巴结转移(P=0.010)和远处转移(P=0.018)有关,而与患者性别、年龄、肿瘤部位、肿瘤大小和临床分期无关.PCNA的表达仅与组织学分级有关(P=0.011),而与其他临床病理因素无关.VEGFR-2和VEGFR-3在死亡患者中的阳性表达率显著高于生存患者(P＜0.05).Cox比例风险模型多因素分析显示,远处转移是影响患者预后的独立因素(OR=0.380,P=0.021).结论 VEGFR-2和VEGFR-3均可作为判断肾乳头状癌预后的指标.VEGFR-3过表达是肾乳头状癌淋巴转移的预后指标,而VEGFR-2可以预测肾乳头状癌血行转移.

Expression of VEGFR-2 and VEGFR-3 in papillary renal cell carcinoma and their relationship with prognosis

Objective To detect the expression of VEGF receptors in papillary renal cell carcinoma and to explore the correlation between their expression and clinical prognosis. Methods Expression of VEGF receptors and PCNA (proliferating cell nuclear antigen) were evaluated in 82 patients with papillary renal cell carcinoma using tissue microarray and SP immunohistochemicat staining. Results The expression of VEGFR-1 in papillary renal cell carcinoma was 82.93%, VEGFR-2 63.41%, VEGFR-3 34.15% andPCNA 67.07%, respectively. Increased VEGFR-2 expression was significantly correlated with tumor size (P=0. 016), histological grade (P =0. 034) and distant metastasis (P =0. 002). VEGFR-3 expression was correlated with histological grade (P = 0. 028 ), lymph node status (P = 0. 010 ) and distant metastasis ( P = 0. 018 ), but not correlated with gender, age, location, tumor size and TNM staging. VEGFR-1expression had no correlation with any clinic and pathologic factors. PCNA expression was correlated with histological grade ( P =0.011 ), but not correlated with other factors. The expression of VEGFR-2 and VEGFR-3 in death cases were higher than that in surviving patients. Conclusion Both VEGFR-2 and VEGFR-3 can serve as markers for prognosis of papillary renal cell carcinoma. Differently, VEGFR-3 is a predictor of lymph node rnetastasis, increased VEGFR-2 expression could be used to precliet a potential blood dissemination.