肾母细胞瘤组织中VEGF-C对微血管和淋巴管的意义.docVIP

  肾母细胞瘤组织中 VEGF-C 对微血管和淋 巴管的意义# 王家祥，马威，杨合英，张大，张国锋* 5 10 15 （郑州大学第一附属医院，郑州 450000） 摘要：目的 探讨小儿肾母细胞瘤组织中 VEGF-C 的表达对微血管、淋巴管生成的影响及其 预后意义。方法 采用免疫组织化学 PV9000 法检测 46 例小儿肾母细胞瘤组织、19 例瘤旁组 织及 8 例正常肾组织中 VEGF-C、CD34 和 LYVE-1 的表达，并进行微血管密度(MVD)和淋 巴管密度(LVD)计数。采用单因素分析 VEGF-C、MVD 和 LVD 与小儿肾母细胞瘤临床病理 特征的关系；采用 Kaplan-Meier 法和 Log-rank 检验评价 VEGF-C、MVD 和 LVD 与患者预 后的关系，并用 Cox 比例风险模型进行多因素分析。结果 VEGF-C 蛋白高表达、MVD 和 LVD 三者在正常肾组织、瘤旁组织和肾母细胞瘤组织中的表达均有统计学差异(P＜0.05)； VEGF-C 高表达、MVD 和 LVD 与肿瘤临床分期、血管浸润、淋巴结转移有关(P＜0.05)， MVD 还与肿瘤的大小有关(P=0.029)；VEGF-C 表达、LVD 和 MVD 三者间相互均有正相关 关系(P＜0.05)；Cox 多因素分析显示，血管浸润、MVD 和 LVD 是影响患者生存的独立危险 因素，化疗程数是影响患者生存的独立保护因素。结论 VEGF-C 高表达促进肾母细胞瘤微 血管和淋巴管的生成，并可促进肿瘤转移而影响患者预后。 关键词：外科学；肾母细胞瘤，血管内皮生长因子；微血管密度；淋巴管密度；预后 中图分类号：R617 20 Significance of vascular endothelial growth factor-C with microvessel and lymphatic vessel in nephroblastoma Wang Jiaxiang, MA Wei, YANG Heying, ZHANG Da, ZHANG Guofeng (The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000) 25 30 35 40 Abstract: Objective To investigate the expression of vascular endothelial growth factor-C and relationship with microvessel and lymphatic vessel and prognostic significance in nephroblastoma. Methods The expression of vascular endothelial growth factor-C was detected by immunohistochemistry (PV9000) method in nephroblastoma (46 cases), tissue adjacent to the tumor (19 cases) and normal kidney tissue (8 cases). The microvessel density (MVD) and lymphatic vessel density (LVD) were assessed after immunohistochemistry with CD34 and LYVE-1. The correlation between the expression of VEGF-C, MVD, LVD and clinicopathological parameters were analyzed by univariate method. The overall survival was evaluated by Kaplan-Meier method and log-rank test. Multivariate analysis was carried out using Cox proportion hazard model. Results The high expression of VEGF-C, MVD and LVD had statistical differences in the above-mentioned 3 kinds of tissues (P＜0.05), three of them also had associated with tumor staging, vascular invasi