血管内皮生长因子 C表达和淋巴管生成与结肠癌进展及预后的关系

目的评估血管内皮生长因子 C( VEGF- C)、淋巴管密度( LMVD)与结肠癌临床病理指标及预后的关系.方法用免疫组织化学法检测 44例原发结肠癌 VEGF- C和 VEGF受体- 3( VEGF R- 3)表达,计数 LMVD,分析上述指标与临床病理指标和预后的关系.结果本组结肠癌 VEGF- C阳性表达率为 43.2%( 19/44), LMVD为 10.14± 4.19. VEGF- C表达与肿瘤分化程度( P=0.003)、淋巴结转移( P=0.002)和 Dukes分期( P=0.001)相关. LMVD与淋巴结转移( P=0.001)和 Dukes分期( P=0.001)相关. VEGF- C表达阳性组 LMVD为 11.34± 4.83,高于 VEGF- C表达阴性组的 9.24± 3.48,但 VEGF- C与 LMVD无相关性( P=0.105). VEGF- C阳性组患者生存率明显低于阴性组( P=0.0225), LMVD阳性组患者生存率明显低于阴性组( P=0.0036).远处转移( P=0.0004)、淋巴结转移( P=0.021)和 LMVD( P=0.0469)可以作为结肠癌独立的预后因素.结论 VEGF- C和 LMVD对于判断结肠癌侵袭性和预后有重要参考价值. LMVD可以作为判断结肠癌预后的独立指标.

Relationship of vascular endothelial growth factor - C and lymphangiogenesis with the development and prognosis of colon cancer

OBJECTIVE: To study the correlation of vascular endothelial growth factor-C (VEGF- C) expression and lymphatic microvessel density (LMVD) with clinicopathological features and prognosis in colon cancer. METHODS: The expression of VEGF-C and VEGFR-3 was detected by immunohistochemical staining with monoclonal antibodies against VEGF-C and VEGFR-3 in 44 cases with primary colon cancer. LMVD was calculated. RESULTS: VEGF-C positive rate was 43.2% (19/44). VEGF-C expression was associated with tumor (P=0.003), lymph node metastasis (P=0.002), Dukes stage (P=0.001). The mean LMVD was 10.14+/- 4.19. LMVD was associated with lymph node metastasis (P=0.002), Dukes stage (P=0.001). LMVD in VEGF-C(+) group was (11.34+/- 4.83) higher than (9.24+/- 3.48) in VEGF-C(-) group, but there was no statistically significance between the two groups (P=0.105). The survival rate of the patients with positive VEGF-C was lower than that with negative VEGF-C (P=0.0225). The median survival time of the patients with LMVD(+) group was shorter than that with LMVD(-) (P=0.0036). Distant metastasis (P=0.0004), lymphatic metastasis (P=0.021) and LMVD (P=0.0469) were independent prognostic factors. CONCLUSIONS: VEGF-C and LMVD appear to be new prognostic factors for colon cancer. Furthermore, LMVD may be a new independent prognostic factor.