CAJ | 학술논문

目的研究胃痛组织中血管内皮生成因子(VEGF)-A、VEGF-C和VEGF-D的表达对血管和淋巴管生成的影响及其预后意义.方法采用免疫组化法检测123例原发性胃癌组织中VEGF-A、VEGF-C和VEGF-D的表达,采用D2-40和CD34免疫组化双染法分别标记淋巴管和血管,并测定淋巴管密度(LVD)和血管密度(MVD).采用单因素分析VEGF-A、VEGF-C和VEGF-D表达与胃癌临床病理特征的关系;采用Kaplan-Meier法和Log rank检验评价VEGF-A、VEGF-C和VEGF-D表达与胃癌患者预后的关系,并用Cox比例风险模型进行多因素分析.结果 123例胃癌组织中,VEGF-A、VEGF-C和VEGF-D的高表达率分别为64.2%、65.9%和41.5%.VEGF-A、VEGF-C或VEGF-D高表达及两两高表达均与LVD有关(均P＜0.05);VEGF-A和VEGF-C高表达还与浸润深度、淋巴管浸润、静脉浸润、淋巴结转移和MVD有关(均P＜0.05);VEGF-C和VEGF-D高表达均与淋巴管浸润和淋巴结转移有关(均P＜0.05).VEGF-A、VEGF-C或VEGF-D高表达者的生存时间均明显短于其低表达者(均P＜0.05),其中VEGF-A和VEGF-C均高表达者的生存时间最短(56个月).VEGF-A的表达水平、MVD、淋巴结转移及浸润深度是影响胃癌患者预后的独立因素.结论 VEGF-A和VEGFC均高表达的胃癌有更强的促进血管和淋巴管生成的能力,并可促进肿瘤转移和影响患者预后;VEGF-C和VEGF-D可共同介导淋巴管生成,促进淋巴结转移;但仅VEGF-A高表达是影响患者预后的独立危险因素.
목적 연구위통조직중혈관내피생성인자(VEGF)-A、VEGF-C화VEGF-D적표체대혈관화림파관생성적영향급기예후의의.방법 채용면역조화법검측123례원발성위암조직중VEGF-A、VEGF-C화VEGF-D적표체,채용D2-40화CD34면역조화쌍염법분별표기림파관화혈관,병측정림파관밀도(LVD)화혈관밀도(MVD).채용단인소분석VEGF-A、VEGF-C화VEGF-D표체여위암림상병리특정적관계;채용Kaplan-Meier법화Log rank검험평개VEGF-A、VEGF-C화VEGF-D표체여위암환자예후적관계,병용Cox비례풍험모형진행다인소분석.결과 123례위암조직중,VEGF-A、VEGF-C화VEGF-D적고표체솔분별위64.2%、65.9%화41.5%.VEGF-A、VEGF-C혹VEGF-D고표체급량량고표체균여LVD유관(균P＜0.05);VEGF-A화VEGF-C고표체환여침윤심도、림파관침윤、정맥침윤、림파결전이화MVD유관(균P＜0.05);VEGF-C화VEGF-D고표체균여림파관침윤화림파결전이유관(균P＜0.05).VEGF-A、VEGF-C혹VEGF-D고표체자적생존시간균명현단우기저표체자(균P＜0.05),기중VEGF-A화VEGF-C균고표체자적생존시간최단(56개월).VEGF-A적표체수평、MVD、림파결전이급침윤심도시영향위암환자예후적독립인소.결론 VEGF-A화VEGFC균고표체적위암유경강적촉진혈관화림파관생성적능력,병가촉진종류전이화영향환자예후;VEGF-C화VEGF-D가공동개도림파관생성,촉진림파결전이;단부VEGF-A고표체시영향환자예후적독립위험인소.
Objective To investigate the expressions of vascular endothelial growth factors (VEGF)-A,-C and-D and their prognostic significance and relation to anglo-and lymphangiogenesis in gastric cancer.nethods The expression of VEGF-A,-C and-D in 123 primary gastric cancers was detected by immunohistochemical staining.The lymphatic vessel density(LVD)and microvesseJ density (MVD)were assessed after immunohistochemical double-staining with D2-40 and CD34.respectively.The correlation between the expression of those VEGF factors and clinicopathological parameters were analyzed by univariate method.The overall survival was evaluated by Kaplan-Meier method and log-rank test.Muhivariate analysis wag carried out using Cox proportion hazard model.Results The positive expression rate of VEGF-A,-C and-D in primary gastric cancer samples were 64.2%,65.9%and 41.5%,respectively.High expression of VECF-A,or-C or-D,or any two of them was correlated with high LVD(P＜0.05).High expression of both VFGF-A and-C was associated with high MVD,lymph node metastasis.LVI and MVI(P＜0.05).Both VEGF-C and -D high expression was correlated with LV1 and lymph node metastasis (P＜0.05).The patients with high expression of these factors had a statistically shorter overall survival (P＜0.05).The patients with both VEGF-A and-C expression had the shortest survival(56 months).Muhivariate analysis showed that VEGF-A high expression,MVD,lymph node metastasis and depth of tumor invasion were independent survival predictors(P=0.033,0.002,0.019 and P＜0.001.respectively).Conclusion High expression of both VEGF-A and-C imply high potential of lymphangiogenesis,metastasis and poorer survival in gastric cancer patients.High expression of VEGF-C and -D may induce lymphangiogenesis and promote lymph node metastasis,but only VEGF-A is an independent predictor of survival.