胰腺导管癌组织中VEGF表达和肿瘤微血管计数的临床意义

目的探讨胰腺癌组织中血管内皮生长因子(VEGF)的蛋白表达、肿瘤微血管(MVD))计数与肿瘤临床病理学特征，研究胰腺肿瘤的预后因素。方法选择病理证实为胰腺导管腺癌且资料完整的48例石蜡切块标本，应用免疫组织化学的方法进行VEGF蛋白检测及MVD计数，与正常胰腺组织及癌旁组织对照，并结合病人临床病理资料进行分析。结果胰腺癌组织中VEGF表达阳性率为64．58％(31／48)。MVD计数为10～34个，中位数为21。VEGF蛋白表达与MVD计数有明显相关性(P＜0．01)。VEGF蛋白表达与肿瘤大小、淋巴结转移和肿瘤TNM分期都有相关性，肿瘤≥2cm比＜2cm的VEGF表达阳性率高(P＜O．05)。有淋巴结转移者VEGF表达阳性率高(P＜0．01)。肿瘤TNM分期Ⅲ～Ⅳ期比Ⅰ～Ⅱ期VEGF表达阳性率高(P＜0．05)。COX分析显示，VEGF蛋白表达及MVD计数与病人生成时间有关。VEGF表达阳性，死亡危险度大；MVD个数多者，死亡危险度大。结论血管生存在胰腺癌的发生、发展和转移过程中起着重要的作用，VEGF和MVD可作为评价胰腺癌预后的指标之一，抗血管治疗可能成为胰腺癌的一种新的治疗手段。

Expression of vascular endothelial growth factor and microvascular density in pancreatic carcinoma, and their clinical significance

Objective To study the expression of VEGF and microvascular density (MVD) in pancreatic carcinoma and their prognostic value. Methods The protein expression of VEGF and MVD were determined with immunohistochemistry in 48 cases of pancreatic ductal carcinomas, which were surgically resected and pathologically confirmed. Results In 64.6% of pancreatic carcinomas the expression of VEGF was positive, and it was significantly higher than that of normal pancreatic tissues (P<0.01). VEGF was positively correlated with stages of clinical and lymphatic metastasis. MVD ranged from 10 to 34 (mean 21). There was positive correlation between MVD and VEGF(P<0.01) . The results of multiple regression analysis suggested that MVD and VEGF were independent predictive factors for survival period after surgical resaction. Conclusions Angiogenesis plays an important role in recurrence and development of pancreatic carcinoma. VEGF and MVD expression are useful prognostic indexes for pancreatic carcinoma. Anti-angiogenetic therapy will be helpful in improving the therapeutic effect surgical resection of pancreatic carcinoma.