睾丸生殖细胞恶性肿瘤血管生成拟态的研究和预后相关性分析*

目的：研究睾丸生殖细胞恶性肿瘤（Testicular germ cell malignant tumors ，TGCMT）中是否存在血管生成拟态（Vasculogenic mimicry ，VM），阐述血管生成拟态的临床意义及相关机制。方法：收集TGCMT组织切片40例临床和预后资料完整，复习切片明确诊断后进行CD34和PAS 双重染色，证实肿瘤组织中VM的结构，利用多因素性相关分析阐述VM的临床意义。结果：40例睾丸生殖细胞恶性肿瘤中VM阳性者22例（53.66％）。 χ2检验分析血管生成拟态的阳性率与肿瘤大小、有无转移以及患者的生存状态之间具有差异，P=0.013，P=0.045，P=0.000。Ka?plan-Meier 生存分析显示有无VM肿瘤患者生存时间差异具有统计学意义，根据Log-rank 检验法比较两组间生存曲线有显著性差异（P=0.012 7）。 Cox 比例风险模型分析表明VM是影响TGCMT患者预后的危险因素（P=0.038，OR= 4.043）。结论：TGCMT中存在VM，VM是影响TGCMT患者预后的危险因素。

Vasculogenic Mimicry in Testicular Germ Cell Malignant Tumor and Its Significance for Prognosis

Objective:To observe vasculogenic mimicry in testicular germ cell malignant tumor and to in -vestigate the mechanism and clinical significance of vasculogenic mimicry in testicular germ cell malignant tu -mors.Methods:Forty cases of testicular germ cell malignant tumor with adequate clinical and pathological da-ta were enrolled. The presence of vasculogenic mimicry was observed by immunohistochemical and histo -chemical double staining of CD34and PAS. The clinical significance of vasculogenic mimicry was assessed. Results: VM channels were found in22of the 40cases of testicular germ cell malignant tumor. Analysis usingthe Chi-sqaure test showed no statistical significance of VM positive rate in patients with different tumor size, metastasis or survival status (P=0.013 , P=0.045 , and P=0.000 ). Kaplan-Meier survival analysis showed that the presence of VM had a negative influence on prognosis (P=0.0127). Cox's proportional hazards model analysis indicated that the presence of VM was significant in predicting patient survival (P=0.038 , OR=4.043 ). Conclusion:VM exists in testicular germ cell malignant tumor and is a risk factor influencing prognosis. Pa-tients with VM have poorer prognosis than those without VM.