血管内皮生长因子C联合CT诊断膀胱癌淋巴结转移的意义  

VEGF-C associated with CT in the diagnosis of lymph node metastasis of bladder carcinoma

作　　者：李卓[1] 祖雄兵[1] 齐范[1] 齐琳[1] 

机构地区：[1]中南大学湘雅医院泌尿外科,湖南长沙410008

出　　处：《中国现代医学杂志》2011年第27期3392-3395,3399,共5页China Journal of Modern Medicine

基　　金：国家自然科学基金资助课题(No:30700832)

摘　　要：目的探讨术前检测血管内皮生长因子C(VEGF-C)的表达,并联合多排螺旋CT(MDCT)扫描诊断膀胱癌淋巴结转移的临床价值。方法采用免疫组化方法研究127例膀胱移行细胞癌行膀胱全切患者术前的肿瘤VEGF-C的蛋白水平的表达,并MDCT平扫及三期强化动态扫描、术后常规病理检查淋巴结有无转移。结果膀胱癌组织中VEGF-C蛋白表达显著高于正常膀胱组织,且淋巴结转移组癌组织中VEGF-C蛋白表达显著高于淋巴结未转移组,两者相比有显著统计学意义,P<0.01。VEGF-C与螺旋CT两者评估膀胱癌淋巴结转移的敏感性、特异性和准确性分别是:87.0%,67.9%,74.8%与47.8%,80.2%,68.5%;VEGF-C联合MDCT诊断淋巴结转移的敏感性为91.3%,特异性为84.0%,准确性为86.6%。结论 VEGF-C与膀胱移行细胞癌淋巴道浸润和转移有显著相关性,检测膀胱移行细胞癌VEGF-C表达能够预示盆腔淋巴结是否转移。术前VEGF-C表达可有效地判断膀胱癌淋巴结转移,联合MDCT扫描可进一步提高准确性。[ Objective ] Vascular endothelial growth factor C （VEGF-C） was demonstrated to stimulate the growth of lymphatic vascular endothelium. The purpose of this study is to determine whether VEGF-C associated with Computerized tomography have relationship with lymph node metastasis in Bladder Transitional Cell Carcinoma （BTCC）. [Methods] We assessed VEGF-C expression using immunohistochemistry in 127 Bladder Transitional Cell Carcinomas. Both plain and enhanced MDCT scan of abdomen and pelvis were performed. Detailed pathologic findings were recorded. [Results]There was VEGF-C expression in the tumor ceils, but very litde in the normal transitional epithelium. In the group of bladder transitional cell carcinoma Positive VEGF-C was significantly correlated with lymph node metastasis （P 〈0.01）. The sensitivity, specificity and accuracy of VEGF-C was 87.0%, 67.9%, 74.8%, respectively. The sensitivity, specificity and accuracy of MDCT was 47.8%, 80.2%, 68.5%, respectively. When VEGF-C associated with MDCT the sensitivity was 91.3%, specificity was 84.0% and accuracy was 86.6%. [ Conclusions] Positive VEGF-C was significantly correlated with lymph node metastasis of the bladder carcinoma. VEGF-C expression in biopsy specimens might be beneficial in predicting pelvic lymph node, It can improve the accuracy when combined MDCT.

关 键 词：膀胱移行细胞癌 血管内皮生长因子C 淋巴结转移 螺旋计算机 

分 类 号：R737.14[医药卫生—肿瘤]