血管内皮生长因子C、D在鼻咽癌组织中的表达及其临床意义

背景与目的:血管内皮生长因子C(vascular endothelial growth factor-C,VEGF-C)和D(vascular endothelial growth factor-D,VEGF-D)是目前已鉴定出的淋巴管生长因子,有研究表明肿瘤组织中VECF-C或VEGF-D过表达与淋巴转移有关.本研究旨在探讨鼻咽癌组织中VEGF-C和VEGF-D的表达情况及其临床意义.方法:采用免疫组化SP法检测66例鼻咽癌组织中VEGF-C和VEGF-D的表达情况,同时检测血管内皮生长因子受体3(vascular endotheliaI growth factor receptor-3,VEGFR-3)和CD34染色情况并计数微淋巴管密度(lymphatic microvessel density,LMVD)和微血管密度(microvessel density,MVD).结果:VEGF-C高表达率在鼻咽癌组织中(54.5%)较鼻咽非肿瘤组织中(26.3%)高(P＜0.05);鼻咽癌伴区域淋巴结转移或T分期晚者,VEGF-C高表达率增高,单因素及多因素Logistic回归分析均表明区域淋巴结转移与VEGF-C高表达相关(P＜0.05),但VEGF-C高表达与性别、年龄、5年生存率、LMVD、MVD等因素无关(P＞0.05).VEGF-D阳性表达率在鼻咽癌组织中(69.7%)较鼻咽非肿瘤组织中(42.1%)高(P＜0.05);鼻咽癌中VEGF-D阳性表达与性别、年龄、T分期、区域淋巴结转移、LMVD、MVD等因素无关(P＞0.05),但与VEGF-C高表达显著正相关(P＜0.01),VEGF-D阳性表达者5年生存率(50.0%)显著低于VEGF-D不表达者(85.0%)(P＜0.01).结论:鼻咽癌中VEGF-C高表达与区域淋巴结转移密切相关;VEGF-D阳性表达与区域淋巴结转移无关,但与VEGF-C高表达正相关,且与5年生存率密切相关.

Expression and clinical significance of vascular endothelial growth factor C and D in nasopharyngeal carcinoma

BACKGROUND & OBJECTIVE:Recently,vascular endothelial growth factor-C(VEGF-C) and-D(VEGF-D) have been identified as specific lymphangiogenic factors,and their overexpression are related to lymphatic metastasis.This study was to investigate the expression and clinical significance of VEGF-C and VEGF-D in nasopharyngeal carcinoma(NPC).METHODS:The expression of VEGF-C,VEGF-D,vascular endothelial growth factor receptor-3(VEGFR-3),and CD34 in 66 specimens of NPC and 19 specimens of nasopharyngitis tissue were detected by SP immunohistochemistry.Lymphatic microvessel density(LMVD) and microvessel density(MVD) were calculated.RESULTS:The high expression rate of VEGF-C was significantly higher in NPC than in nasopharyngitis tissues(54.5% vs.26.3%,P<0.05).The high expression rate of VEGF-C was significantly higher in the NPC with regional lymph node metastasis than in those without,and higher in the NPC with high T stage than in those with low T stage(P<0.05).Both univariate and multivariate logistic regression analyses showed that high expression of VEGF-C was correlated to regional lymph node metastasis(P<0.05),but not to age,sex,5-year survival,LMVD,and MVD(P>0.05).The positive rate of VEGF-D was significantly higher in NPC tissues than in adjacent non-cancerous tissues(69.7% vs.42.1%,P<0.05).In NPC tissues,VEGF-D expression had no correlations to age,sex,T stage,regional lymph node metastasis,LMVD,and MVD(P>0.05),but was positively related to high expression of VEGF-C.The 5-year survival rate was significantly lower in VEGF-D-positive NPC than in VEGF-D-negative NPC(50.0% vs.85.0%,P<0.05).CONCLUSION:In NPC,high expression of VEGF-C is closely correlated to regional lymph node metastasis;positive expression of VEGF-D shows no correlation to regional lymph node metastasis,but is positively related to high expression of VEGF-C and closely correlated to 5-year survival rate.