CAJ | 학술논문

目的探讨非小细胞肺癌(NSCLC)微血管构筑二维表型(2D-TMAP)的结构特征及临床意义.方法完整采集30例NSCLC肺内结节标本.按其活体解剖方位选取与多层螺旋CT灌注成像最大层面相当的病理层面,构建该病理层面2D-TMAP.运用Spearman相关分析探讨2D-TMAP各指标与NSCLC临床病理特征的关系.结果 2D-TMAP在NSCLC组织中呈异质性表达,不同区域微血管密度(MVD)无明显差异,周同区未形成完整管腔的MVD明显多于中心区(P值为0.030).总MVD与分化程度无明显关系(r=0.042,P=0.831),周围区未形成完整管腔的MVD与分化程度及淋巴结转移正相关(r值分别为0.528,0.533,P值分别为0.041,0.028)与血管内皮生长因子(VEGF)、ephrinB2、EphB4和增殖细胞核抗原(PCNA)表达强度呈正相关(r值分别为0.504、0.549、0.549、0.370,P值分别为0.005、0.002、0.002、0.048).分化程度与PCNA、VEGF表达强度呈正相关(r值分别为0.604、0.370,P值分别为0.001和0.048),与基底膜完整性呈负相关(r=0.531,P=0.033).结论 2D-TMAP能观察肿瘤生长微环境的整体状态,对血管新生与肿瘤增殖的调控呈网状结构.深入探讨2D-TMAP表达调控机制具有重要的临床意义.
목적 탐토비소세포폐암(NSCLC)미혈관구축이유표형(2D-TMAP)적결구특정급림상의의.방법 완정채집30례NSCLC폐내결절표본.안기활체해부방위선취여다층라선CT관주성상최대층면상당적병리층면,구건해병리층면2D-TMAP.운용Spearman상관분석탐토2D-TMAP각지표여NSCLC림상병리특정적관계.결과 2D-TMAP재NSCLC조직중정이질성표체,불동구역미혈관밀도(MVD)무명현차이,주동구미형성완정관강적MVD명현다우중심구(P치위0.030).총MVD여분화정도무명현관계(r=0.042,P=0.831),주위구미형성완정관강적MVD여분화정도급림파결전이정상관(r치분별위0.528,0.533,P치분별위0.041,0.028)여혈관내피생장인자(VEGF)、ephrinB2、EphB4화증식세포핵항원(PCNA)표체강도정정상관(r치분별위0.504、0.549、0.549、0.370,P치분별위0.005、0.002、0.002、0.048).분화정도여PCNA、VEGF표체강도정정상관(r치분별위0.604、0.370,P치분별위0.001화0.048),여기저막완정성정부상관(r=0.531,P=0.033).결론 2D-TMAP능관찰종류생장미배경적정체상태,대혈관신생여종류증식적조공정망상결구.심입탐토2D-TMAP표체조공궤제구유중요적림상의의.
Objective To investigate the structural characteristics and clinical significance of two-dimensional tumor microvascular architecture phenotype (2D-TMAP) in non-small cell lung cancer (NSCLC). Methods Thirty surgical specimens of NSCLC were collected. The sections of the tumor tissues corresponding to the slice of CT perfusion imaging were selected to construct the 2D-TMAP expression. Spearman correlation analysis was used to examine the relation between the 2D-TMAP expression and the clinicopathological features of NSCLC. Resluts A heterogeneity was noted in the 2D-TMAP expression of NSCLC. The microvascular density (MVD) in the area surrounding the tumor was higher than that in the central area, but the difference was not statistically significant. The density of the microvessels without intact lumen was significantly greater in the surrounding area than in the central area (P=0.030). The total MVD was not correlated to tumor differentiation (r=0.042, P=0.831). The density of the microvessels without intact lumen in the surrounding area was positively correlated to degree of tumor differentiation and lymph node metastasis (r=0.528 and 0.533, P=0.041 and 0.028, respectively), and also to the expressions of vascular endothelial growth factor (VEGF), ephrinB2, EphB4, and proliferating cell nuclear antigen (PCNA) (r=0.504, 0.549, 0.549, and 0.370; P=0.005, 0.002, 0.002, and 0.048, respectively). The degree of tumor differentiation was positively correlated to PCNA and VEGF expression (r=0.604 and 0.370, P=0.001 and 0.048, respectively), but inversely to the integrity of microvascular basement membrane (r=-0.531, P=0.033). Conclusion The 2D-TMAP suggests the overall state of the micro-environment for tumor growth. The 2D-TMAP of NSCLC regulates angiogenesis and tumor cell proliferation through a mesh-like structure, and better understanding of the characteristics and possible mechanism of 2D-TMAP expression can be of great clinical importance.