VEGF-C、VEGFR-3在食管癌诊治中的临床价值  

Clinical significance of VEGF-C and VEGFR-3 in the diagnosis and treatment of esophageal cancer

作　　者：卢来顺[1] 林雪琼[2] 曾芸珠 LU Laishun;LIN Xueqiong;ZENG Yunzhu(Department of Ultrasound Diagnosis,Shantou Central Hospital,Shantou 515041,China;Clinical Laboratory,Cancer Hospital of Shantou University Medical College,Shantou 515041,China;Department of Pathology,Cancer Hospital of Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头市中心医院超声诊断科,广东汕头515041 [2]汕头大学医学院附属肿瘤医院检验科,广东汕头515041 [3]汕头大学医学院附属肿瘤医院病理科,广东汕头515041

出　　处：《汕头大学医学院学报》2021年第3期166-171,177,共7页Journal of Shantou University Medical College

基　　金：广东省医学科研基金(粤卫科教函[2020]15号);汕头市科技计划项目(汕府科[2018]121号,汕府科[2020]58号)。

摘　　要：目的:探讨血管内皮细胞生长因子-C(vascular endothelial growth factor-C,VEGF-C)和血管内皮细胞生长因子受体-3(vascular endothelial growth factor receptor-3,VEGFR-3)在食管癌诊治中的临床价值。方法:收集2014年5月—2016年4月汕头大学医学院附属肿瘤医院病理科收检的部分食管癌手术标本134例。采用免疫组化法检测标本中VEGF-C、VEGFR-3、凋亡抑制蛋白Survivin等表达水平,分析VEGF-C、VEGFR-3的表达与食管癌临床病理特征、患者生存时间的关系。结果:淋巴结转移组VEGF-C、VEGFR-3阳性率分别为88.10%和62.00%,无淋巴结转移组的阳性率分别为77.40%和54.00%,差异有统计学意义(P<0.05)。VEGF-C、VEGFR-3与Survivin蛋白的表达呈正相关(P<0.05)。VEGF-C低表达食管癌患者的中位生存期长于VEGF-C高表达患者(32.7个月比28.2个月,P=0.049),VEGFR-3低表达食管癌患者中位生存期亦长于VEGFR-3高表达患者(32.2个月比27.6个月,P=0.025)。多因素生存分析结果表明,淋巴结转移是食管癌患者的独立预后预测因子(OR=2.297,95%CI:1.031~5.118,P=0.042),VEGF-C、VEGFR-3不是食管癌患者的独立预后预测因子(OR=1.921,95%CI:0.640~5.764,P=0.244;OR=1.515,95%CI:0.663~3.462,P=0.325)。结论:VEGF-C、VEGFR-3表达的高低与食管癌患者是否伴有淋巴结转移密切相关,两者表达与Survivin的表达呈正相关;VEGF-C、VEGFR-3表达越高提示食管癌患者伴有淋巴结转移可能性越大且预后越差。Objective:To investigate the clinical significance of vascular endothelial growth factor-C(VEGF-C)and vascular endothelial growth factor receptor-3(VEGFR-3)in the diagnosis and treatment of esophageal cancer.Methods:From May 2014 to April 2016,134 cases of esophageal cancer surgical specimens examined by the Department of Pathology,Cancer Hospital of Shantou University Medical College were collected.The expression levels of VEGF-C,VEGFR-3,Survivin,etc.in the specimens were detected by immunohistochemistry.The relationship between the expression of VEGF-C,VEGFR-3 and clinicopathological features,survival time of patients with esophageal cancer was analyzed.Results:The positive rates of VEGF-C and VEGFR-3 in lymph node metastasis group were 88.10% and 62.00%,respectively,and those in non-lymph node metastasis group were 77.40%and 54.00%,respectively,with significant difference(P<0.05).VEGF-C,VEGFR-3 and Survivin protein expression were positively correlated(P<0.05).The median survival time of patients with low expression of VEGF-C was longer than that of patients with high expression of VEGF-C(32.7 months vs 28.2 months,P=0.049),and the median survival time of patients with low expression of VEGFR-3 was longer than that of patients with high expression o£VEGFR-3(32.2 months vs 27.6 months,P=0.025).Multivariate survival analysis showed that lymph node metastasis was an independent prognostic factor for esophageal cancer(OR=2.297,95%CI:1.031-5.118,P=0.042),while VEGF-C and VEGFR-3 were not independent prognostic factors for esophageal cancer(0R=1.921,95%CI:0.640-5.764,P=0.244;OR=1.515,95%CI:0.663-3.462,P=0.325)o Conclusion:The expression of VEGF-C and VEGFR-3 is closely related to lymph node metastasis in patients with esophageal cancer,and the expression of VEGF-C and VEGFR-3 is positively correlated with the expression of Survivin;The higher the expression of VEGF-C and VEGFR-3,the higher the possibility of lymph node metastasis and the worse the prognosis.

关 键 词：食管癌 血管内皮细胞生长因子-C 血管内皮细胞生长因子受体-3 淋巴结转移 

分 类 号：R446.6[医药卫生—诊断学]