宫颈癌VEGF-C表达和淋巴管、血管生成关系的探讨

目的:检测宫颈癌组织中血管内皮生长因子-C(VEGF-C)、受体VEGFR-3和CD34的表达,探讨VEGF-C与癌周淋巴管、血管生成和肿瘤转移的关系。方法:采用免疫组化法检测55例宫颈癌组织中VEGF-C、VEGFR-3和CD34的表达。结果:55例宫颈癌组织VEGF-C阳性率为69.1%(38/55),VEGFR-3阳性率为61.8%(34/55),二者表达高度一致(P<0.01)。淋巴结转移组中VEGF-C与VEGFR-3阳性表达明显高于无转移组(P<0.05)。低分化组VEGF-C和VEGFR-3的表达明显高于高、中分化组(P<0.05)。随着临床分期增加,VEGFR-3表达的阳性率增高(P<0.01)。淋巴结转移组中淋巴管密度(LMVD)明显高于无转移组(P<0.01)。VEGF-C表达阳性的组织中血管密度(MVD)明显升高(P<0.05)。VEGF-C和VEGFR-3表达阳性的患者生存率有降低的趋势。结论:宫颈癌中VEGF-C通过受体VEGFR-3促进组织生长、抑制分化,促进肿瘤细胞间质淋巴管和血管生成,是促使宫颈癌发生扩散和转移的重要原因。二者阳性表达可预示预后不良。

The expression of vascular endothelial growth factor-C and its relationship with lymphangiogenesis,angiogengsis in cervical cancer

Objective:To study the expressions of vascular endothelial growth factor-C(VEGF-C),VEGFR-3,CD34 in cervical cancer and their relationships with lymph node metastasis,angiogenesis and explore the significance of lymphangiogenesis on metastasis via lymphtcis.Methods:Paraffinembedded specimens from 55 patients with primary cervical cancer and 45 patients of them who had undergone radical hysterectomy with lymph node dissection were studied.VEGF-C,VEGFR-3,CD34 expressions were investigated by immunohistochemical staining.Rusults:The positive rate of VEGF-C was 69.1%(38/55) and the positive rate of VEGFR-3 was 61.8%(34/55).A significant positive correlation was found between VEGF-C in cancer cells and VEGFR-3 in lymphatic endothelial cells(P<0.01) and both were significantly associated with lymph node metastasis(P<0.05).VEGF-C and VEGFR-3 expression in cervical cancer was associating with the differentiation of tumor cells(P<0.05).The number of microvascular in VEGF-C positive tumors was significantly greater than that in VEGF-C negative tumors(P<0.05).The LMVD had a significant positive correlation with lymph node metastasis(P<0.01).The patients with VEGF-C and VEGFR-3 positive expression show a tendency of decreased survival rate.Conclusions:VEGF-C facilitates tumor metastasis via the lymphatic vessels.VEGF-C and VEGFR-3 are expressed in cervical cancer and related to pelvic lymph node metastasis.The system of VEGF-C and its receptors can promote lymphangiogenesis and anginogenesis in cervical cancer.The positive expression of VEGF-C and VEGFR-3 is indicated with the poor prognosis of cervical cancer.