化疗对切除困难小儿实体肿瘤血管生成的影响  

Influence and clinical significance of chemotherapy on angiogenesis in pediatric difficult removal solid tumor

作　　者：王志超[1] 邸玉琴 徐伟立[1] 周辉[1] 杨晓锋[1] 李索林[1] 

机构地区：[1]河北医科大学第二医院小儿外科,石家庄050000 [2]河北医科大学第二医院小儿内科,石家庄050000

出　　处：《中华实用儿科临床杂志》2014年第6期474-477,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：河北省科技厅计划项目（062761255）

摘　　要：目的探讨化疗对临床难以切除小儿实体肿瘤微血管密度（MVD）及血管内皮生长因子（VEGF）的影响。方法2002年1月至2012年1月河北医科大学第二医院小儿外科收治的80例Ⅲb—Ⅳb期实体肿瘤患儿，经影像学及术前查体显示均为难以一期切除的恶性肿瘤，经肿瘤病理活检后分为神经母细胞瘤组25例，肝母细胞瘤组25例，肾母细胞瘤组30例。3种肿瘤患儿均按病理结果实施化疗后行手术切除。统计每组患儿的手术切除率，分别应用免疫组织化学法检测对比各组术前活检标本、手术后大体标本中MVD及VEGF的表达情况。结果化疗后各组手术切除率分别为神经母细胞瘤80．00％（20／25例），肝母细胞瘤92．00％（23／25例），肾母细胞瘤96．67％（29／30例），各组问比较差异无统计学意义（χ2=4．286，P=0．117）。神经母细胞瘤、肝母细胞瘤、肾母细胞瘤化疗前VEGF阳性率分别为80．00％（20／25例）、90．00％（18／20例）和83．33％（25／30例），MVD值分别为48．39±15．87、52．16±16．12和46．82±19．07。化疗后神经母细胞瘤、肝母细胞瘤、肾母细胞瘤各组VEGF阳性率分别为52．00％（13／25例）、45．00％（9／20例）和30．00％（9／30例），MVD值分别为31．31±14．21、25．19±15．31和29．06±13．05，与化疗前比较均有显著下降，差异均有统计学意义（P均〈0．05）。结论术前化疗可有效提高临床上切除困难小儿实体恶性肿瘤的手术切除率，MVD值和VEGF可作为判断化疗疗效和能否提高手术切除率的评价指标。Objective To explore the influence and clinical significance of chemotherapy on the expressions of micro-vessel density （MVD） and vascular endothelial growth factor （VEGF） in pediatric difficult removal solid tumor. Methods From Jan. 2002 to Jan. 2012, totally 80 cases of the hospitalized pediatric patients with solid tumor Ⅲb-Ⅳb stage） were enrolled in this study in Department of Pediatric Surgery of the Second Hospital of Hebei Medical Uni- versity. All of the tumors were identified as difficult removal malignant tumor by imageology and physical examinations. After biopsy of the tumors, these patients were divided into neuroblastoma group （25 cases）, hepatoblastoma group （25 cases） and Wilms＇ tumor group （30 cases）. All patients in these 3 groups underwent chemotherapy respectively ac- cording to their different pathologic findings, thereafter, the tumor resections were performed. The resection rates of tumor in each groups were recorded and the expressions of MVD and VEGF between preoperative biopsy and postopera- tive specimens were detected and compared by immunohistochemistry in different groups. Results With chemotherapy, the resection rate of neurohlastoma was 80.00% （ 20/25 cases）, hepatoblastoma was 92.00% （ 23/25 cases ） and Wilms＇ tumor was 96.67% （29/30 cases）. There was no significant difference among them （χ2 = 4. 286 ,P = 0.117 ）. Before chemotherapy, the positive expressions of VEGF in neuroblastoma, hepatoblastoma and Wilms＇ tumor were 80.00% （20/25 cases） ,90.00% （ 18/20 cases） and 83.33 % （25/30 cases） respectively, at the same time, the values of MVD were 48.39 ± 15.87,52.16 ± 16. 12 and 46.82 ± 19.07. After chemotherapy, the expressions of VEGF and MVD in neuroblastoma, hepatoblastoma and Wilms＇ tumor were 52.00% （ 13/25 cases） , 45.00% （ 9/20 cases ） , 30.00% （9/30 cases） and 31.31 ± 14.21,25.19 ± 15.31 and 29.06 ± 13.05. Compared with the expressions of them in each group before chemotherapy, significant diffe

关 键 词：实体肿瘤 化疗 微血管密度 血管内皮生长因子 儿童 

分 类 号：R730.5[医药卫生—肿瘤]