VEGF和MVD可作为判断胃癌患者预后和上消化道出血风险的指标

背景:血管内皮生长因子(VEGF)是主要血管生成调控因子之一,与肿瘤血管发生密切相关,微血管密度(MVD)是评价肿瘤血管发生的重要指标。有研究发现VEGF表达和MVD与胃癌患者的上消化道出血(UGIB)风险相关。目的:探讨VEGF和MVD与胃癌患者临床病理特征、预后和UGIB风险的关系。方法:收集60例伴或不伴UGIB胃癌患者的胃癌手术标本石蜡包埋组织,以免疫组化方法检测VEGF表达和MVD(计数CD34阳性血管内皮细胞)。结果:胃癌组织VEGF阳性表达率为51.7%(31/60),MVD均值为35.18±19.72。伴UGIB的胃癌患者VEGF阳性表达率和MVD均值显著高于不伴UGIB者(VEGF:64.5%对37.9%,P<0.05;MVD:42.70±15.50对27.13±20.80,P<0.01)。VEGF表达和MVD均与胃癌T分期和pTNM分期呈正相关(P<0.01),VEGF表达与肿瘤组织分化呈负相关(P<0.05),MVD与N分期呈正相关(P<0.001)。COX多元回归分析显示MVD是影响胃癌患者术后生存时间的危险因素,而VEGF与术后生存时间无关。结论:VEGF表达和MVD与胃癌患者的临床病理进展和UGIB风险相关,MVD为胃癌患者术后生存时间的重要影响因素,两者可共同作为判断胃癌患者预后和UGIB风险的有效指标。

VEGF and MVD as Predictors for Prognosis and Risk of Upper Gastrointestinal Bleeding in Patients with Gastric Cancer

Vascular endothelial growth factor （VEGF） is a major angiogenic factor associated with tumor angiogenesis, and microvessel density （MVD） is an important marker for assessing tumor angiogenesis. It has been reported that VEGF expression and MVD were correlated with the risk of upper gastrointestinal bleeding （UGIB） in patients with gastric cancer. Aims： To investigate the correlation of VEGF and MVD with clinicopathological characteristics, prognosis and risk of UGIB in patients with gastric cancer. Methods： A total of 60 cases of gastric cancer patients with or without UGIB were collected, and the paraffin-embedded surgical resected gastric cancer tissues were examined by immunohistochemistry using anti-VEGF and anti-CD34 antibodies. MVD was calculated by counting CD34-positive vascular endothelial cells. Results： VEGF was positively expressed in 51.7% （31/60） of the cancerous tissues, and the average value of MVD in cancerous tissues was 35. 18 ± 19.72. The positivity rate of VEGF and average value of MVD were significantly higher in patients with UGIB than those without （VEGF： 64.5% vs. 37.9%, P 〈 0.05; MVD： 42.70 ± 15.50 vs. 27.13 ± 20.80, P 〈 0.01 ）. Both VEGF expression and MVD were positively correlated with T staging and pTNM staging （ P 〈 0.01 ）, while tumor differentiation was negatively correlated with VEGF expression （ P 〈 0.05 ） and N staging was positively correlated with MVD （P 〈 0. 001 ）. MVD was identified as a risk factor for postoperative survival by COX multivariate regression analysis, but no relationship was found between VEGF and patients＇ survival. Conclusions： VEGF expression and MVD are correlated with clinicopathological progression and risk of UGIB in patients with gastric cancer. Furthermore, MVD is an important predictor for postoperative survival. Both VEGF and MVD might be used as valuable factors to predict the prognosis and risk of UGIB in patients with gastric cancer.