VEGF表达及MVD与肝细胞癌侵袭、转移和预后的关系  

RELATIONSHIP BETWEEN VEGF EXPRESSION ,TUMOR ANGIOGENESIS AND INVASION ,METASTASIS AND PROGNOSIS OF HEPATOCELLULAR CARCINOMA

作　　者：李志伟[1] 鲁广恩[1] 胡安国[1] 杨五计[1] 戴勇[2] 

机构地区：[1]济南铁路中心医院普外科,济南250001 [2]山东大学齐鲁医院普外科,济南250012

出　　处：《中国现代医学杂志》2003年第16期15-17,20,共4页China Journal of Modern Medicine

基　　金：铁道部济南铁路局科委资助项目

摘　　要：目的 :探讨原发性肝细胞癌 (HCC)血管内皮生长因子 (VEGF)及肿瘤新生血管生成与临床病理及HCC侵袭、转移和预后的关系。方法 :采用免疫组织化学方法 ,检测了 2 0例正常肝组织、2 0例肝硬化组织、5 0例HCC组织中VEGF和CD34的表达 ,以及HCC的微血管密度 (MVD)。结果 :VEGF阳性表达为癌细胞胞浆棕黄色着色 ,CD34的染色定位在血管内皮细胞上 ,HCC窦样血管CD34表达为强阳性 ;除门管区小血管分支及中央静脉外 ,癌旁肝组织、肝硬化组织、正常肝组织基本不表达CD34;HCC的MVD范围 / 32～ 2 32 ) / 0 .74mm2 ,平均 (14 8.5± 5 3.2 ) / 0 .74mm2 。HCC的VEGF表达及MVD与肿瘤大小、病灶数目、病理分级、门静脉癌栓形成、包膜是否完整均有显著关系 (P <0 .0 5或 0 .0 1) ;与患者年龄、HBsAg是否阳性无关 (P >0 .0 5 ) ;与预后亦有关 ,VEGF阴性表达及少血管组 (MVD <14 8)预后显著优于VEGF阳性表达及多血管组 (MVD≥14 8) ,术后平均无瘤生存期少血管组为 4 6个月 ,多血管组为 12个月 ,(P <0 .0 1)。结论 :CD34的表达反映了HCC的新生血管化 ,VEGF和MVD可作为判断HCC侵袭、转移和预后的指标。Objective:To investigate the relationship between vascular endothelial growth factor(VEGF) expression, tumor angiogenesis and the clinicopathological variables of hepatocellular carcinoma(HCC) and determine whether VEGF expression and tumor angiogenesis can be used as an indicator for predicting invasion, metastasis and prognosis of HCC. Methods:Using the immunohistochemical S-P method, VEGF and CD34 expressions were detected and the microvascular density(MVD) was determined in tumor tissue from 50 patients with HCC. Results:VEGF was located in the call cytoplasm of tumor cells and CD34 mainly in the cell cytoplasm of endothelial cells. The CD34 staining was confined to vessels in the portal triad in the normal liver tissue. In HCC tissues, however, sinusoid-like vessels reacted intensively with anti-CD34 and the MVD was 148.5 ±53.2(per 0.74mm 2 ). VEGF expression and MVD were closely correlated to tumor size, number, differentiation, emboli in the portal vein and capsule ( P <0.05). They were also correlated with prognosis of HCC. The mean tumor-free survival of MVD >148 was 12 months while that of MVD <148 was 46 months ( P <0.01). Conclusions:Angiogenesis in HCC is associated with the progression of HCC. The expression of VEGF and MVD can be used as an indicator to judge the invasion, metastasis and prognosis of HCC.

关 键 词：肝细胞癌 VEGF CD34 新生血管生成 

分 类 号：R735.7[医药卫生—肿瘤]