食管鳞癌组织中血管内皮生长因子C、皮层肌动蛋白的表达及其临床意义  

Vascular endothelial growth factor C and cortactin expression in esophageal squamous cell carcinoma and its clinical sSignificance

作　　者：张九娜[1] 李校天[2] 瞿峰[3] 魏红[4] 翟山[3] 翟建文[4] 郭永泽[2] 路新卿[2] 王飞[1] 

机构地区：[1]承德医学院研究生院,067000 [2]河北工程大学附属医院消化内科 [3]河北工程大学附属医院病理科 [4]河北工程大学附属医院胸外科

出　　处：《中国综合临床》2016年第4期319-324,共6页Clinical Medicine of China

基　　金：河北省自然科学基金（H2014402078）

摘　　要：目的探讨血管内皮生长因子C（VEGF-C）、皮层肌动蛋白（CTTN）在食管鳞癌组织中的表达及D2-40标记的食管鳞癌淋巴管浸润（LVI）与临床病理特征和预后的关系。方法采用免疫组织化学法检测216例食管鳞癌和癌旁正常食管黏膜组织中VEGF-C和CTTN蛋白表达及LVI的情况，分析其与食管鳞癌临床病理特征之间的关系，随访观察患者总生存期。结果VEGF-C、CTYN在食管鳞癌和癌旁正常食管黏膜组织中的阳性表达率比较差异均有统计学意义[43．1％与10．6％，63．9％与25．5％，χ2值分别为28．874、32．259，P均〈0．0001]；216例食管鳞癌患者淋巴管浸润率为63．9％。食管鳞癌组织中VEGF-C、CTTN的表达与浸润深度（pT）（χ2值分别为10．759、13．958）、TNM分期（χ2值分别为11．476、16．299）、淋巴结转移（pN）（χ2值分别为15．473、23．728）和LVI（χ2值分别为16．370、23．594）相关，差异均有统计学意义（P均〈0．001）。Logistic单因素和多因素回归分析均显示VEGF-C、CTTN、LVI和TNM分期是预测淋巴结转移的独立影响因素（P值分别为0．001、0．006、0．004、0．003）；而在单因素分析中浸润深度是影响淋巴结转移的独立因素（P=0．042），但多因素分析中浸润深度不能成为预测淋巴结转移的独立危险因素。Kaplan-Meier生存分析显示VEGF-C（-）组的中位生存时间51．0个月，高于VEGF-C（＋）组的中位生存时间28．0个月；CqTN（-）组的中位生存时间54．0个月，显著高于CTTN（＋）组的中位生存时间26．0个月；VEGF-C和CTTN的Logrank值分别为11．810、18．100，差异均有统计学意义（P均〈0．001）。同时Kaplan-Meier生存分析显示LVI（＋）组中位生存时间26．0个月明显低于LVI（-）组的中位生存时间54．0个月，差异有统计学意义（P〈0．000）。Cox多因素分析示浸润深度pT、TNM分期、LVI、VEGF-C、CTTN为影响食�Objective To investigate the clinicopathological role of expression of vascular endothelial growth factor C （ VEGF-C ） , cortactin （ CTTN ） and lymphatic vessel invasion （LVI） detected by the D2-40 monoclonal antibody, whether their expression are independent predictors of the prognosis of esophageal squamous cell carcinoma（ESCC） . Methods The expression of VEGF-C, CTTN and LVI labled by D2-40 in 216 patients with ESCC were examined by Immunohistochemically. The correlation between the clinicopathologic feature and the overall survival time of the patients was analyzed. The overall survival of patients was followed up. Results The positive rate of VRGF-C and CTT＇N in ESCC were 43.1%, 63.9%, higher than normal esophageal mucosa adjacent to carcinoma （ 10. 6%, 25.5%） , the differences were significant （χ2 = 28. 874, 32. 259;P〈0. 0001） . The total rate of LVI in 216 patients of ESCC was 63.9%. Positive expression of VEGF-C or CTTN was found to correlate significantly with depth of tumor invasion（pT） （χ2 = 10. 759, 13. 958） ,TNM stage（χ2= 11. 476, 16. 299 ） , lymph node metastasis （pN） （ χ2= 15. 473,23.728 ） and LVI （ χ2= 16. 370, 23. 594） , and the differences were significant（P〈0. 001 ） . Logistic single factor and multi factor regressionanalysis showed that VEGF-C, CTTN, LVI, TNM stage were the independent influencing factors of lymph node metastasis （P= 0. 001,0. 006,0. 004,0. 003 ） . Although univariate analysis showed that depth of tumor invasion was a statistically predictors of lymph node metastasis （ P = 0. 042 ） , this was not shown in multivariate analysis. The Kaplan-Meier analysis showed that the median overall survival of VEGF-C-positive patients was 28.0 months and that of the VEGF-C negative patients was 51.0 months with significance; the median overall survival of CTI＇N positive group was 26. 0 months and that of the CTTN negative group was 54. 0 months with significance as well. Log rank value of VEGF-C and CTTN were 11. 810, 1

关 键 词：食管鳞癌 血管内皮生长因子C 皮层肌动蛋白 淋巴管浸润 淋巴结转移 

分 类 号：R735.2[医药卫生—肿瘤]