肾上腺皮质癌中血管拟态和VEGFR-2的表达及临床意义  

Clinical Significances of Vasculogenic Mimicry and VEGFR-2 in Adrenocortical Carcinoma

作　　者：张发明[1] 林浩[1] 潘金成[1] 庄锦涛[1] 陈旭[1] 黄斌[1] 王道虎[1] 丘少鹏[1] 

机构地区：[1]中山大学附属第一医院泌尿外科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2015年第2期215-220,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81272809)

摘　　要：【目的】探讨血管拟态(VM)在肾上腺皮质癌(ACC)中是否存在、临床意义及相关机制。【方法】收集中山大学附属第一医院1999年1月至2014年3月病理确诊39例ACC患者病理切片,行CD34与过碘酸Schiff双染及血管内皮生长因子受体-2(VEGFR-2)免疫组织化学染色,分析VM和VEGFR-2与临床预后间关联性。【结果】17例ACC标本中,发现VM(17/39,43.59%),VM与Weiss评分(P<0.05),TNM分期(P<0.05),VEGFR-2(P<0.05)存在一定联系;VM与VEGFR-2阳性患者中位生存期较VM与VEGFR-2阴性患者短,两者生存曲线差异有统计学意义;单因素分析发现年龄、肿瘤大小、Weiss评分、TNM分期、VEGFR-2、VM可能影响患者预后,但多因素分析结果表明VM是ACC患者预后的独立风险因子。【结论】ACC中存在VM,VM可作为评估ACC预后的风险指标,VEGFR-2可能参与ACC中VM的形成,为ACC的血管靶向治疗提供新的理论依据。【Objectives】 To study the clinical significance and underlined mechanisms of vasculogenic mimicry（VM） in adrenocortical carcinoma（ACC）. 【Methods】 Thirty-nine formalin-fixed and paraffin-embedded samples of ACC diagnosed between January 1999 and March 2014 were collected and stained for CD34, periodic acid and Schiff（PAS）, and vascular endothelial growth factor receptor-2（VEGFR-2）. Clinicopathologic data of the patients was analyzed. Exact probability method was used to analyze the relationship between VM,VEGFR-2 and clinicopathologic parameters of ACC. 【Results】 VM was detected in 17 of the 39 ACC samples. The VM in ACC was associated with Weiss score（P = 0.017）, TNM stage（P = 0.024）, and VEGFR-2（P = 0.012）, but not with the patient＇s gender, age, tumor location, hormone secretion, or tumor size（cm）.The median overall survival time of patients with VM-positive and VEGFR-2-positive was significantly shorter than that of the patients with VM-negative and VEGFR-2-negative tumors（P〈0.05）. Single factor analysis showed that age, tumor size, Weiss score, TNM staging, VEGFR-2-positive, VM-positive may affect the prognosis of ACC patients. Furthermore, the multivariate analysis demonstrated that VM were independent risk factors for the prognosis of patients with ACC. 【Conclusions】 VM was presented in ACC tissues, and was associated with VEGFR-2overexpression. This may indicate that the relative molecular pathways could be potential therapeutic targets for ACC.

关 键 词：肾上腺皮质癌 血管拟态 血管内皮生长因子受体-2 

分 类 号：R69[医药卫生—泌尿科学]