直肠癌中血管内皮生长因子C和血小板衍生生长因子AA、BB的表达及其与淋巴管生成和淋巴结转移的关系

目的探讨血管内皮生长因子C（VEGF-C）、血小板衍生生长因子（PDGF）-AA、PDGF-BB在直肠癌组织中的表达情况及其与患者淋巴管生成和淋巴结转移之间的关系。 方法采用免疫组织化学SP法检测60例直肠癌组织（直肠癌组）和30例正常组织（对照组）中VEGF-C、PDGF-AA和PDGF-BB的表达。应用D2-40检测直肠癌中微淋巴管密度（LMVD），并做相关统计分析。 结果VEGF-C、PDGF-AA和PDGF-BB在直肠癌组织中阳性表达率均显著高于对照组(VEGF-C：63.3% vs 3.3%，P<0.05；PDGF-AA：40.0% vs 13.3%，P<0.05；PDGF-BB：55.0% vs 6.7%，P<0.05)。VEGF-C和PDGF-BB在淋巴结阳性组的阳性表达率较淋巴结阴性组均显著升高（VEGF-C：86.4% vs 50.0%，P<0.01；PDGF-BB：77.3% vs 42.1%，P<0.05），但PDGF-AA表达与淋巴结转移无关（54.5% vs 31.6%，P>0.05）。直肠癌中淋巴结阳性组的LMVD高于淋巴结阴性组[（13.11±2.01）/mm² vs (8.13±2.99）/mm²，P<0.05]，VEGF-C、PDGF-AA和PDGF-BB阳性表达组的LMVD高于阴性表达组[VEGF-C：（12.06±2.20） /mm² vs（6.32 ±2.41） /mm²，P<0.05；PDGF-AA：（11.89± 2.46）/mm² vs （8.67±3.67）/mm²，P<0.05；PDGF-BB：（12.19±2.22） /mm² vs（7.33 ±3.02）/mm²，P<0.05]。直肠癌中VEGF-C、PDGF-AA、PDGF-BB三者的表达具有显著相关性（VEGF-C vs PDGF-AA：r_s=0.366，P<0.05；VEGF-C vs PDGF-BB：r_s=0.650，P<0.05；PDGF-AA vs PDGF-BB：r_s=0.320，P<0.05）。 结论淋巴管生成是直肠癌淋巴结转移的重要原因之一，VEGF-C、PDGF-AA和PDGF-BB均参与直肠癌淋巴管生成，进而促进淋巴结转移，且三者可能存在一定的协同作用。针对VEGF-C、PDGF-AA、PDGF-BB的联合用药可能更利于直肠癌淋巴结转移的防治。

Relationship among the expression of vascular endothelial growth factor C,platelet-derived growth factor-AA and -BB,lymphangiogenesis and lymph node metastasis in rectal cancer

ObjectiveTo investigate the expression of vascular endothelial growth factor C (VEGF-C), platelet-derived growth factor (PDGF)-AA and PDGF-BB in rectal cancer tissues and their relationship with lymphangiogenesis and lymph node metastasis. MethodsThe expression of VEGF-C, PDGF-AA and PDGF-BB in 60 cases of rectal cancer (the rectal cancer group) and 30 cases of normal tissues (the control group) were detected by immunohistochemical staining (SP method). The microlymphatics density (LMVD) in rectal cancer was measured by D2-40, and the correlated analysis was conducted. ResultsThe positive expression rates of VEGF-C, PDGF-AA and PDGF-BB in the rectal cancer tissues were significantly higher than those in control group (VEGF-C: 63.3% vs 3.3%, P<0.05; PDGF-AA: 40.0% vs 13.3%, P<0.05; PDGF-BB: 55.0% vs 6.7%, P<0.05). The positive rates of VEGF-C and PDGF-BB in lymph node positive group were significantly higher than those in lymph node negative group (VEGF-C: 86.4% vs 50.0%, P<0.01; PDGF-BB: 77.3% vs 42.1%, P<0.05), but there was no evidence show that PDGF-AA was correlated with lymph node metastasis (54.5% vs 31.6%, P>0.05). LMVD in the lymph node positive group was significantly higher than that in the lymph node negative group [(13.11±2.01) /mm² vs (8.13±2.99) /mm², P<0.05], LMVD in VEGF-C, PDGF-AAand PDGF-BB positive expression group was significantly higher than that of negative expression group[VEGF-C: (12.06±2.20)/mm² vs (6.32±2.41)/mm², P<0.05; PDGF-AA: (11.89±2.46)/mm² vs(8.67±3.67)/mm², P<0.05; PDGF-BB: (12.19±2.22)/mm² vs (7.33±3.02)/mm², P<0.05 ]. The expression of VEGF-C, PDGF-AA and PDGF-BB in rectal cancer was significantly correlated (VEGF-C vs PDGF-AA: r_s=0.366, P<0.05; VEGF-C vs PDGF-BB: r_s=0.650, P<0.05; PDGF-AA vs PDGF-BB: r_s=0.320, P<0.05). ConclusionsLymphangiogenesis is one of the important reasons for lymph node metastasis of rectal cancer. VEGF-C, PDGF-AA and PDGF-BB all can promote lymph node metastasis by participating in lymphangiogenesis of rectal cancer, and they may have a certain synergistic effect. Combined medication for VEGF-C, PDGF-AA and PDGF-BB may be more conducive to the prevention and treatment of lymph node metastasis of rectal cancer.