食管癌NOS同功酶和VEGF活性表达与血管生成及其意义

目的　研究食管癌iNOS、cNOS及VEGF表达 ,探讨NO作用双向性在食管癌发生、发展中的意义及其与VEGF的关系。方法　手术切除的食管鳞癌标本 75例 ,免疫组化法检测iNOS ,cNOS和VEGF活性表达及微血管计数 (MVD)。结果　iNOS、cNOS及VEGF阳性表达分别为 4 4 %、6 0 %及30 .7%。iNOS与组织学分级有关 ,即随着分化程度降低 ,iNOS活性越低 (P =0 .0 15 ) ;MVD在淋巴结转移者明显高于未转移者 (P =0 .0 0 3) ;iNOS与VEGF表达呈显著正相关 (P =0 .0 0 3) ;术后复发与组织学分级、iNOS表达缺失、MVD计数及淋巴结转移有关 (P值分别为 0 .0 0 3、0 .0 2 1、0 .0 4 1、0 .0 0 2 )。结论　i NOS在低分化型肿瘤的表达缺失 ,提示肿瘤预后不良。MVD计数及iNOS活性检测可作为食管癌预后判断的独立预测因素。

Expression of NOS isozymes, VEGF and micro vessel density in 75 primary esophageal squamous cell carcinomas

Objective This study was to investigate the expression of different nitric oxide synthase isozymes(NOSII-III) and vascular endothelial growth factor in the primary esophageal squamous cell carcinomas. A further analysis was performed to correlate the immunohistochemical data with tumor angiogenesis and clinicopathologic features. Methods Surgical specimens from 75 primary esophageal squamous cell carcinomas were examined for iNOS,cNOS,VEGF expression and micro vessel density by immunocytochemical staining. Results The positive rate of iNOS,cNOS,VEGF was 44%(33/75), 60%(45/75), 30.7%, respectively. Significant correlations were observed for the iNOS expression of the well differentiated carcinomas with the poor(P= 0.015),VEGF with iNOS(P= 0.003). There was a close correlation between micro vessel density and lymph node status(P= 0.003). The operative recurrence was significantly associated with poor differentiated tumors, low expression of iNOS, micro vessel density and high incidence of lymph node metastases.Conclusion NO plays an important role in primary esophageal squamous cell carcinoma. There may exist some defective NO-mediated macrophages in poor differentiated tumors. Micro vessel density and lower expression of iNOS may be as independent prognosis factors,this may help select patients for preoperative radiation and chemotherapy or determine the extent of surgery performed for esophageal carcinoma.