血管内皮生长相关因子在胰腺癌组织中的表达

目的 观察胰腺癌组织中的血管内皮生长相关因子:色素上皮衍生因子(PEDF)和血管内皮生长因子(VEGF)的表达以及胰腺癌中PEDF和VEGF平衡关系的变化与其预后的关系.方法 用SP免疫组织化学方法检测51例胰腺癌标本,观察PEDF和VEGF在胰腺癌中的表达以及相应的微血管密度(MVD),并和肿瘤血管密度、肿瘤浸润深度、肿瘤大小、血管侵犯、肿瘤病理TNM分期、淋巴结转移、远处转移等临床病理指标作单因素和多因素COX回归分析.结果 PEDF/VEGF与MVD之间明显关系(P<0.01),PEDF/VEGF值大小与肿瘤病理TNM分期(P<0.01)、淋巴结转移(P<0.01)、远处转移(P<0.05)有密切关系.Kaplan-Meier生存曲线分析,51例患者根据PEDF/VEGF值是否大于0.5分为两组,其中PEDF/VEGF≥0.5组生存曲线明显高于PEDF/VEGF<0.5组(log-rank test,P<0.01).PEDF/VEGF比值(风险系数0.390;P<0.05)、淋巴结转移(风险系数3.38;P<0.01)、远处转移(风险系数3.447;P<0.01)是胰腺癌独立的预后指标.结论 PEDF/VEGF比值可较好反映胰腺癌中的血管增生;它与胰腺癌患者的临床分期、淋巴结转移及远处转移相关,是胰腺癌重要的预后因子之一.

The expression of pigment epithelium-derived factor and vascular endothelial growth factor in pancreatic carcinoma

Objective To investigate the expression of pigment epithelium-derived factor (PEDF) and vascular endothelial growth factor (VEGF) in pancreatic carcinoma and evaluate its prognostic implications mirrored by the ratio of the PEDF/VEGF. Methods The expression of PEDF and VEGF in pancreaticcarcinoma was detected immunohistochemically by SP method, and prognostic factors of clinical stage, microvessel density (MVD) , infiltration depth, lymph node metastasis, metastasis were analyzed by multivariate factors analysis of COX regression model. Results The expression rate of PEDF and VEGF was 16% and 96% respectively. The ratio of PEDF/VEGF ranged from 0. 25 to 3 and the mean ratio was 0. 514;The ratio was significantly relate with clinical stage (P < 0. 01) , MVD (P < 0.01) , lymph node metastasis (P<0. 01). Univariate factor analysis revealed a significantly short survival, in patients with low PEDF/VEGF ratio (P<0. 01). By multivariate COX regression analysis, PEDF/VEGF ratio (risk factor=0. 390,P<0. 05) was an independent poor risk prognostic factor. Conclusion The high ratio of PEDF/VEGF is a predictor of advanced stage and poor survival in patients with pancreatic carcinoma.