癌组织VEGF表达与原发性肝细胞癌进展的关系研究

目的 探讨血管生成与原发性肝细胞癌进展的关系。方法 收集1993年～2000年41例病人的手术切除病理证实与原发性肝细胞癌的标本，行免疫组化染色（SABC法）检测血管内皮生长因子（VEGF）的表达以及肿瘤组织和肿瘤旁组织的微血管密度（MVD）。其中男34例，女7例；年龄35～65岁，平均48．8岁；肿瘤直径≤5cm者13例，〉5cm者28例，有包膜者19例，无包膜者22例。细胞学分级：Ⅰ级8例，Ⅱ级18例，Ⅲ级11例。Ⅳ级4例。门静脉或（和）肝静脉有癌栓形成者7例，无癌栓者34例。HbsAg或HBcAb阳性者33例，阴性者8例。结果 VEGF表达阳性率为70．7％（29／41）。VEGF的表达与MVD呈显著正相关（P〈0．01）。VEGF的阳性表达率与肿瘤病灶大小、有无静脉癌栓呈显著相关，肿瘤直径大、病期晚者表达率显著增高（P〈0．05或0．01）。有包膜的肿瘤VEGF表达率显著低于无包膜者。VEGF的表达与细胞学分级和是否有肝炎病毒感染无显著性相关。结论 肝细胞癌中VEGF的分泌增多可导致微血管数目增加，促进了其进展和转移。肿瘤较大、分期较晚的病例血管生成活性高，提示预后较差。

Study of relationship between VEGF expression and tumor progress of primary hepatocellular carcinoma

Objective] To explore the relationship between angiogenesis and primary hepatocellular carcinoma (HCC) progress. Methods] The 41 specimens of pathological confirmed HCC from 1993 to 2000 were collected.The tests of vascular endothelial growth factor(VEGF) expression and intratumor and paratumor microvessel density(MVD) were performed by immunohistochemical stain(SABC manner). Thirty-four were males and 7 were females.The mean age was 48.8 years (35～65 years). Thirteen tumor diameter ≤5 cm, and 28 ＞5 cm. Nineteen had envelop and 22 had no. Histograde I were in 8 cases, Ⅱ in 18, Ⅲ in 11, and Ⅳ in 4. Seven cases had carcinothrombosis in portal vein or(and) liver vein, 34 had no. HBsAg or HCV were positive in 33 and negative in 8. Results] VEGF positive rate were 70.7%(29/41). VEGF expression was significantly correlated with MVD (P ＜0.01).VEGF positive rate was markedly higher in the patients with bigger tumor diameter and later clinical pathological stage (P ＜0.05 or0.01). VEGF expression rate in group of envelop presence was lower than that in group of envelop absence. VEGF expression was no related with histograde and hepatovirus infection. Conclusions] More VEGF secrete in HCC may result in MVD increase, and promote its progress and metastasis. Angiogenesis increase in the patients of bigger tumor diameter and later pathological stage indicates the poor prognosis.