喉及下咽部鳞状细胞癌中血管内皮生长因子-c及其受体FLT-4表达与淋巴结转移的相关研究

目的：研究喉及下咽部鳞状细胞癌组织中血管内皮生长因子-C（VEGF-C）及其受体VEGFR-3（FLT-4）的表达情况，以及它们在肿瘤淋巴转移、微转移中的作用和意义。方法：采用免疫组织化学SP法及图像分析技术，检测49例喉及下咽部痛组织中VEGFC、FLT-4及淋巴结中VEGF-C蛋白表达和相对含量。结果：喉及下咽部癌组织中VEGF-C的表达与病理分级密切相关（均P〈0．05），与淋巴结转移之间存在相关关系（均P〈0．05），与临床T分期无关。FLT-4表达与VEGF-C阳性表达呈同向性改变，与淋巴结转移相关（均P〈0．05）；喉及下咽部癌组织中，FLT-4阳性脉管数与病理分级及临床T分期差异无统计学意义（均P〉0．05）。喉及下咽部癌组织中淋巴结微转移组，VEGFC、FLT-4表达与无转移组之间的差异无统计学意义（P〉0．05）。结论：VEGFC在喉及下咽部癌组织中，通过其特异性受体FLT-4导致淋巴管增生，促进肿瘤淋巴转移，从而影响患者的预后；检测VEGF-C、FLT-4，对肿瘤诊断、判断患者预后具有重要临床价值。

The expression and role of VEGF-C and its receptor FLT-4 in laryngeal and hypopharyngeal squamous cell carcinoma metastasis

Objective:To investigate the expression of VEGF-C and its receptor FLT-4 in laryngeal and hypopharyngeal squamous cell carcinoma,and to analyse its role in lymphatic metastasis and micrometastasis.Method:Forty-nine cases postoperative specimens verified by histopathology were studied.The expression of VEGF-C,FLT-4 were detected with immunohistochemical SP method,image analysis method.The clinicopathological parameters of tumor were compared with the immunohistochemical results of VEGF-C and FLT-4, followed by the further analysis on the relationship between VEGF-C/FLT-4 expression and lymph nodal metastasis or micrometastasis.Result:There was a statistical correlation between the expression of VEGF-C and grades of pathological differentiation in laryngeal and hypopharyngeal squamous cell carcinoma.Moreover there was also a statistical correlation between the expression of VEGF-C and lymph node metastases. But no correlation was observed between the expression of VEGF-C and clinical T grades. The statistical correlation also existed between VEGF-C and FLT-4 expression in laryngeal or hypopharyngeal tumors. There was a significant difference of expression of FLT-4 in laryngeal and hypopharyngeal tumours with positive and negative lymph node metastases. No correlation was observed between FLT-4 and grades of pathological differentiation or clinical T grades. There was no statistical correlation between the expression of VEGF-C/FLT-4 and nodal micrometastasis P>0.05).Conclusion:VEGF-C and its receptor FLT-4 play an important role in the lymphatic metastasis of laryngeal and hypopharyngeal squamous cell carcinoma.VEGF-C/FLT-4 may be a useful biological marker to foresee the cervical lymph node metastasis and prognosis.