胰腺癌组织中p53、血管内皮生长因子的表达与血管生成的关系及其临床意义

目的 探讨胰腺癌组织中p53、血管内皮生长因子(VEGF)和血管生成的关系。方法 用免疫组织化学方法检测48例胰腺癌组织及癌旁组织、6例正常胰腺组织中p53、VEGF表达和微血管密度(MVD)。结果 胰腺癌组织中VEGF、p53的阳性表达率分别为54.17％和50％,显著高于癌旁组织及正常组织的表达率(P<0.01),胰腺癌组织中MVD显著高于癌旁组织及正常组织。VEGF表达与肿瘤大小和分期有关(P=0.038,P=0.045),VEGF表达与MVD有相关性(r=0.294 P=0.043)。p53与淋巴结转移及预后相关(P<0.05)而与VEGF、MVD之间无关。MVD与胰腺癌临床病理特征无关,MVD与生存期存在负相关(r=0.371 P=0.011)。多元回归分析显示p53、VEGF和MVD都不是影响胰腺癌预后的独立因素。结论 p53基因突变为胰腺癌分子事件的晚期事件,可作为评价胰腺癌预后的一项指标,抗血管生成可能有利于胰腺癌的治疗。

Correlation of p53 and vascular endothelial growth factor expression with angiogenesis in pancreatic carcinoma and its clinical significance.

Objective To investigate the relationship of the expression of p53 and vascular endothelial growth factor (VEGF) with angiogenesis in pancreatic carcinoma. Methods Using immunohistochemical staining, the expression of p53, VEGF and microvascular density (MVD) was examined in 48 cases of pancreatic carcinoma and paracarcinoma and 6 cases of normal pancreatic tissue (control). Results The expression of VEGF and p53 was found respectively in 54. 17% and 50% of carcinoma cases, which was significantly higher than that of paracarcinoma and normal tissues (P < 0. 01 ). MVD was significantly higher in tumors than in paracarcinoma and normal tissues. The expression of VEGF was correlated with the size and stage of pancreatic tumors. There was a close correlation between VEGF and MVD(r=0. 294 P = 0. 043). A correlation was found between the expression of p53 and lymph node metastasis or the prognosis of pancreatic cancer (P < 0. 05) and no correlation between P53 and VEGF or MVD. No correlation was detected between MVD and clinicopathological characterization. There was a negative correlation between MVD and survival (r = - 0. 371 P = 0. 011). There was a correlation between P53. Multivariate regression analysis showed that neither p53 nor VEGF or MVD was an independent prognostic factor. Conclusions p53 gene inactivation is a late event in genetic progression of pancreatic carcinoma and can be used as a marker to evaluate the prognosis of pancreatic carcinoma. Postoperative antiangiogenic therapy may be beneficial to the treatment of pancreatic carcinoma.