微血管密度和血管套及血管内皮生长因子在子宫颈癌中的表达

目的 :研究微血管密度 (MVD)、血管套 (VC)和血管内皮生长因子 (VEGF)在子宫颈癌组织中的表达与子宫颈癌的生长、浸润及转移的关系。方法 :采用免疫组织化学方法 (SP)检测 5 7例子宫颈癌 (鳞癌 30例、腺癌 2 0例、腺鳞癌 7例 ) ,2 9例宫颈上皮内肿瘤 (CIN)和 16例正常子宫颈组织中 VEGF蛋白的表达 ,以 CD34抗原作为血管内皮细胞标记 ,测定其微血管密度及癌巢与基质间的血管套。结果 :随着宫颈病变的进展 ,MVD逐渐增高 ,VC表现明显 ,VEGF的阳性表达率渐增高。MVD在以上 5组间差异有显著性 (P<0 .0 1)。正常组 VC与各组癌之间差异有显著性 (P<0 .0 1)。 VEGF在正常宫颈组织、CIN、子宫颈鳞癌、腺癌、腺鳞癌细胞浆中的阳性表达率分别为 :18.8% (3/ 16)、82 .8% (2 4 / 2 9)、93.3% (2 8/ 30 )、10 0 % (2 0 / 2 0 )、7/ 7(10 0 % ) ,差异有显著性 (P<0 .0 1)。 MVD与VEGF的表达呈正相关 (rs=0 .335 ,P<0 .0 1) ,VEGF的不同表达强度与 MVD的表达量间差异均有显著性 (P<0 .0 1)。子宫颈癌淋巴转移者 MVD的表达量较阴性者高 (P<0 .0 5 )。结论 :VEGF在子宫颈癌的发生发展中有促进血管形成作用 ,MVD与子宫颈癌的恶性程度密切相关。

Microvessel density, epithlial-stromal vascular cuffing and expression of vascular endothelial growth factor in human cervical carcinoma

Objective: To observe microvessel density(MVD), epithlial-stromal vascular cuffing(VC) and expression of vascular endothelial growth factor(VEGF) in human cervical carcinomas and to clarify their significance in the invasion and metastasis of cervical carcinoma. Methods: VEGF and CD34 were stained immunohistochemically (SP) in 57 cases of cervical carcinoma (30 cases of squamous-cell carcinoma, 20 of adenocarcinoma,7 of glandular and squamous-cell carcinoma), 29 cases of cervical intraepithelial neoplasia (CIN) and 16 cases of normal cervices, meanwhile, MVD and VC were also assayed. Results: There were significant differences among the above 5 groups for MVD(P<0.01). The VC pattern showed a significant difference between cervical carcinoma and CIN or control group(P<0.01). The positive rates of VEGF in normal cervical epithelium, CIN, squamous-cell carcinoma, adenocarcinoma, glandular and squamous-cell carcinoma were 18.8%(3/16),82.8%(24/29), 93.3%(28/30),100%(20/20) and 7/7(100%), respectively. There were significant differences between these cervical lesion groups and the control group(P<0.001). The MVD showed significant differences between the positive pelvic node metastasis and negative pelvic node metastasis(P<0.05). There was no significant correlation between the expression of VEGF and the tumor diameter, clinical stage, pathologic grade and pelvic node metastasis. Conclusion: The expression of VEGF may play an important role in the angiogenesis of cervical carcinoma. Degree of malignacy of cervical carcinoma has a close association with microvessel density.