CAJ | 학술논문

目的：研究血管内皮生长因子（VEGF）、CD34在小儿肝脏血管内皮细胞瘤（IHHE）组织中的表达，探讨VEGF在血管内皮细胞瘤诊断和治疗中的作用。方法14例肝脏血管内皮细胞瘤石蜡标本来自2002年7月至2009年7月北京儿童医院手术切除并经病理诊断的临床病例，术前未行其他治疗，并选取小儿肝脏恶性肿瘤组织（肝母细胞瘤20例），其他肝脏良性肿瘤组织（结节样增生10例，错构瘤10例）及IHHE瘤旁组织作为对照组；空白对照选取良性肿瘤术中切取部分肝脏组织。组织切片SP法进行免疫组织化学染色，兔抗VEGF和CD34相关抗原标记；计算出VEGF表达阳性率，CD34相关抗原抗体检测出肿瘤间质血管，分析其表达的不同及相互关系。应用统计软件进行数据分析。结果①VEGF在肝母细胞瘤组织中表达率为90.0％（18/20），在良性肿瘤组中表达阳性率为10.0％（2/20）；VEGF在正常肝组织、瘤旁组织中呈低水平、稳定表达，染色浅，而在IHHE肿瘤组织中则呈阴性表达。在肝母细胞瘤组阳性表达率明显高于其他组，差异有显著性（P＜0.05），其余两两比较，差异均无显著性（P＞0.05）。②CD34在已知正常肝组织肝窦处未见阳性表达；在IHHE组织中的阳性表达率为100.0％（14/14），肝母细胞瘤为90.0％（18/20），肝脏良性肿瘤为15.0％（3/20），瘤旁组织未见表达。MVD在IHE，肝母细胞瘤组，良性肿瘤组及瘤旁组织分别为31.55±4.86，29.75±5.56，11.23±3.97。结论 IHHE中，高表达CD34，低表达VEGF，表明其不是单纯的血管、内皮细胞病变，很有可能是血管瘤与血管畸形的混合体。IHE增殖期抗血管生成治疗可能促进肿瘤退化。
목적：연구혈관내피생장인자（VEGF）、CD34재소인간장혈관내피세포류（IHHE）조직중적표체，탐토VEGF재혈관내피세포류진단화치료중적작용。방법14례간장혈관내피세포류석사표본래자2002년7월지2009년7월북경인동의원수술절제병경병리진단적림상병례，술전미행기타치료，병선취소인간장악성종류조직（간모세포류20례），기타간장량성종류조직（결절양증생10례，착구류10례）급IHHE류방조직작위대조조；공백대조선취량성종류술중절취부분간장조직。조직절편SP법진행면역조직화학염색，토항VEGF화CD34상관항원표기；계산출VEGF표체양성솔，CD34상관항원항체검측출종류간질혈관，분석기표체적불동급상호관계。응용통계연건진행수거분석。결과①VEGF재간모세포류조직중표체솔위90.0％（18/20），재량성종류조중표체양성솔위10.0％（2/20）；VEGF재정상간조직、류방조직중정저수평、은정표체，염색천，이재IHHE종류조직중칙정음성표체。재간모세포류조양성표체솔명현고우기타조，차이유현저성（P＜0.05），기여량량비교，차이균무현저성（P＞0.05）。②CD34재이지정상간조직간두처미견양성표체；재IHHE조직중적양성표체솔위100.0％（14/14），간모세포류위90.0％（18/20），간장량성종류위15.0％（3/20），류방조직미견표체。MVD재IHE，간모세포류조，량성종류조급류방조직분별위31.55±4.86，29.75±5.56，11.23±3.97。결론 IHHE중，고표체CD34，저표체VEGF，표명기불시단순적혈관、내피세포병변，흔유가능시혈관류여혈관기형적혼합체。IHE증식기항혈관생성치료가능촉진종류퇴화。
Objetive To investigate the expression of vascular endothelial growth factor(VEGF)and CD34 in Infantile hepatic hemangioendothelioma(IHHE),and discuss the role of VEGF in the diagnosis and treatment of IHHE. Methods Fourteen ceases of IHHE,twenty malignant tumors (20 cases of hepatoblasto-ma),twenty benign neoplasm (1 0 cases of nodular hyperplasia,1 0 cases of hamartoma ),and fourteen cases of the periphery tissues of IHHE with paraffin section were collected from the Beijing Children’s hospital from July 2002 to July 2007. All the cases were diagnosed by pathology in the primary disease without any preopera-tive treatment. The malignant tumors,benign liver tissue and IHHE periphery tissue were employed as the con-trol group;the parts of the liver tissue were selected as blank control. The specimen sections were treated with immunohistochemistry of SP method,lebaled with rabbit anti-VEGF and CD34 antigen marker.The VEGF and CD34 expression rate were calculated. The expression of VEGF and CD34 were analyzed respectively and their relationship was discussed. Statistical analyses were carried out with statistics software. Results The percent-age of the expression of VEGF in hepatoblastoma tissue and in benign neoplasm tissue was 90.0%(1 8/20), 1 0.0%(2/20)respectively. And the expression of VEGF in normal hepatic was low and stable,but in IHHE was negative. The expression in hepatoblastoma was significantly higher than the others (P<0.05 ). There was no significant difference among the IHHE,benign neoplasm,and the periphery tissues of IHHE. (P>0.05 ).The expression of CD34 was negative in normal hepatic sinusoid,But in IHHE,hepatoblastoma,and benign neoplasm tissue,the percentage of the expression of CD34 was 1 00.0%(1 4/1 4),90.0%(1 8/20),1 5.0%(3/20)respectively. The count of MVD was 31.55 ±4.86,29.75 ±5.56,1 1.23 ±3.97,and 0 respectlvely in IHHE,hepatoblastoma,benign neoplasm tissue and the periphery tissues of IHHE. Conclusion The high expression of CD34,but low in VEGF were showed in IHHE,which may indicate that IHHE was not a pure blood vessels or endothelial cell lesions,but a mixture of hemangioma and vascular malformations. In the phase of proliferation,anti-angiogenesis therapy may promote IHHE degradation.