CAJ | 학술논문

目的观察视网膜母细胞瘤(RB)未行综合治疗和行综合治疗后微血管密度(MVD)、血管内皮生长因子(VEGF)表达以及与RB肿瘤视神经浸润和综合治疗后复发的关系.方法 61例RB石蜡标本纳入研究.分为未行综合治疗直接摘除眼球(未治疗)组、综合治疗前计划眼球摘除(计划眼摘)组、综合治疗后肿瘤复发(复发)组,3组分别为52、6、3例.其中,未治疗组中,视神经未侵润33例,已侵润19例.应用CD34单克隆抗体、VEGF单克隆抗体、链霉菌抗生物素蛋白-过氧化物酶连结法(SP)免疫组织化学法,对61例石蜡标本行MVD、VEGF表达测定;免疫组织化学和实时定量聚合酶链反应方法检测计划眼摘组和复发组VEGF的表达,观察MVD、VEGF表达.结果未治疗组RB浸润视神经者其MVD多于未浸润视神经者,二者比较,差异有统计学意义(t=-2.468 5,P=0.017).RB浸润者视神经VEGF表达高于未浸润视神经者,二者比较,差异有统计学意义(χ2=8.416 6,P=0.032 8).计划眼摘组,在全身化学治疗过程中,肿瘤组织微血管消退,MVD降低,部分血管闭塞,玻璃样变.复发组肿瘤组织中可见大量新生微血管,MVD增加.计划眼摘组的VEGF表达低于复发组VEGF表达.结论未行综合治疗与行综合治疗者之间RB VEGF阳性表达差异无统计学意义;未行综合治疗者RB MVD增加、VEGF阳性表达均与肿瘤视神经浸润有关;行综合治疗后RB复发可能与MVD增加有关.
목적 관찰시망막모세포류(RB)미행종합치료화행종합치료후미혈관밀도(MVD)、혈관내피생장인자(VEGF)표체이급여RB종류시신경침윤화종합치료후복발적관계.방법 61례RB석사표본납입연구.분위미행종합치료직접적제안구(미치료)조、종합치료전계화안구적제(계화안적)조、종합치료후종류복발(복발)조,3조분별위52、6、3례.기중,미치료조중,시신경미침윤33례,이침윤19례.응용CD34단극륭항체、VEGF단극륭항체、련매균항생물소단백-과양화물매련결법(SP)면역조직화학법,대61례석사표본행MVD、VEGF표체측정;면역조직화학화실시정량취합매련반응방법 검측계화안적조화복발조VEGF적표체,관찰MVD、VEGF표체.결과 미치료조RB침윤시신경자기MVD다우미침윤시신경자,이자비교,차이유통계학의의(t=-2.468 5,P=0.017).RB침윤자시신경VEGF표체고우미침윤시신경자,이자비교,차이유통계학의의(χ2=8.416 6,P=0.032 8).계화안적조,재전신화학치료과정중,종류조직미혈관소퇴,MVD강저,부분혈관폐새,파리양변.복발조종류조직중가견대량신생미혈관,MVD증가.계화안적조적VEGF표체저우복발조VEGF표체.결론 미행종합치료여행종합치료자지간RB VEGF양성표체차이무통계학의의;미행종합치료자RB MVD증가、VEGF양성표체균여종류시신경침윤유관;행종합치료후RB복발가능여MVD증가유관.
Objective To observe the microvessel density (MVD)and expression of vascular endothelial growth factor (VEGF) in retinoblastoma(RB)before and after comprehensive treatment and explore its clinical correlations with tumor infiltration and recurrence. Methods Sixty-one paraffin specimens of RB were divided into enucleation without comprehensive treatment group (untreated group,52cases), planned enucleation before comprehensive treatment group (planned enucleation group, six cases)and tumor recurrence after comprehensive treatment group(recurrence group,three cases). There were optic nerve invasion in 19 cases,no optic nerve infiltration in 33 cases. The MVD and VEGF expressions of 61paraffin specimens were detected by streptavidin biotin-peroxidase (SP) immunohistochemistry with monoclonal antibody of CD34 and VEGF. Real time PCR was performed for the VEGF expression of planned enucleation group and recurrence group. Results In the untreated group, the MVD and VEGF expression of optic nerve infiltration cases were significantly higher than those of cases without optic nerve infiltration(t= -2. 4685, P=0. 017;χ2 =8. 416 6,P=0.032 8). Tumor microvessel regression, decreased MVD, occlusion and hyaline changes of blood vessels were observed in the planned enucleation group in the course of systemic chemotherapy. Many neovascularized capillaries and increased MVD were observed in tumor tissues of the recurrence group. The VEGF expression of planned enucleation group was lower than that in the recurrence group. Conclusions There was no significant difference on VEGF expression in RB between with and without comprehensive treatment. The increasing MVD and VEGF expression of cases without comprehensive treatment were related to the optic nerve infiltration. And the increasing MVD may also play an important role in RB recurrence after comprehensive treatment.