nm23和血管内皮生长因子表达及微血管密度与骨肉瘤转移的关系  

Expression of nm23 and vascular endothelial growth factor and microvessel density in osteosarcomas and its correlation with lung metastasis

作　　者：沈为栋[1] 李康华[1] 郑晖[2] 刘佑明 

机构地区：[1]中南大学湘雅医院骨科,长沙410008 [2]中南大学湘雅医院病理科,长沙410008 [3]湖南省岳阳市第三人民医院骨科研究室

出　　处：《中华实验外科杂志》2003年第6期495-496,F003,共3页Chinese Journal of Experimental Surgery

摘　　要：目的　探讨nm2 3和血管内皮生长因子 (VEGF)表达及微血管密度与骨肉瘤转移的关系。方法　用免疫组织化学法检测 40例骨肉瘤组织中nm2 3、VEGF的表达和微血管 (MV)密度。结果　骨肉瘤中nm 2 3阳性信号呈浆型和 /或核浆型 ,阳性表达率为 85 .0 0 % ,其中有肺转移的病例阳性率为 81.2 5 % ,无肺转移病例的阳性率为 87.5 0 % ,差异无显著性 (P >0 .0 5 ) ;VEGF的阳性率为 65 .0 0 % ,其中有肺转移者的阳性率 ( 87.5 0 % )明显高于无肺转移者 ( 5 0 .0 0 % ) ,阳性信号主要位于细胞胞浆 ,其阳性信号强度与骨肉瘤的组织学类型无关 ,但与是否有肺转移显著相关 (P <0 .0 1)。骨肉瘤中VEGF表达强度与MV密度呈明显正相关 (r =0 .72 5 6) ;有肺转移患者的骨肉瘤组织中MV密度明显高于无肺转移者 (P <0 .0 1)。结论　在骨肉瘤的发生发展中VEGF是促进MV生成的主要细胞因子 ;VEGF可能是通过促进MV生成而增加恶性肿瘤细胞侵入血管 ,导致早期血道转移 ,但nm 2 3的表达水平与骨肉瘤的转移发生无关 ,检测VEGF表达与MV密度值可作为判断骨肿瘤预后的重要指标。Objective To study the expression of nm23 and vascular endothelial growth factor and microvessel density in osteosarcomas and its correlation with lung metastasis.Methods Immunohistochemistry was performed to detect the expression of nm23,VEGF and MV density in 40 osteosarcoma tissues.Results In osteosarcoma tissues,the positive signal of nm23 was localized in cytoplasm and/or nuclei.The positive rate of nm23 in osteosarcoma was 85.00%,in which the positive rate was 81.25% in osteosarcomas with lung metastasis,and 87.50% in osteosarcomas without lung metastasis.There was no significant difference between them.The positive rate of VEGF in osteosarcoma was 65.00%,in which the positive rate in osteosarcomas with lung metastasis was significantly higher than that in osteosarcomas without lung metastasis.The positive signal of VEGF was mainly localized in cytoplasma of tumor cells.The intensity of VEGF signal in osteosarcomas was not associated with classification of osteosarcoma (P >0.05),but was closely correlated to lung metastasis (P <0.01).There was significant positive correlation between the expression intensity of VEGF and MV density in osteosarcomas ( r = 0.725?6). MV density in osteosarcomas with lung metastasis was higher than that in osteosarcomas without lung metastasis ( P <0.01).Conclusion VEGF may be a main factor stimulating angiogenesis in osteosarcoma genesis and development,and result in early blood vessel metastasis by stimulating angiogenesis and increasing invasion vessel of malignant cells,but expression level of nm23 was not related to metastasis of osteosarcoma.Detection of VEGF expression and MV density may be a useful indicator in judging prognosis of malignant bone tumors.

关 键 词：NM23 血管内皮生长因子 微血管密度 骨肉瘤 免疫组织化学 预后 

分 类 号：R738.1[医药卫生—肿瘤]