直肠癌组织ｕＰＡ系统和ＶＥＧＦ表达与浸润转移的关系.DOCVIP

临床医学论文-直肠癌组织ｕＰＡ系统和ＶＥＧＦ表达与浸润转移的关系 【摘要】 目的 研究尿激酶型纤溶酶原激活系统uPA,uPAR,PAI-1蛋白及血管内皮生长因子(VEGF)在直肠癌组织中的表达及其与直肠癌癌生物学行为的关系。方法 2005年1月至2006年1月，采用免疫组化S-P法检测67例直肠癌及癌旁组织中uPA,uPAR,PAI-1及VEGF蛋白表达情况，同时对临床病理学资料进行回顾性分析。结果 癌和癌周比较uPA,uPAR,PAI-1及VEGF蛋白阳性表达率明显升高(P0.01)，阳性产物主要分布在癌细胞胞质。侵及浆膜组阳性率明显高于未及浆膜组(P=0.000,0.014,0.016,0.000)。uPA,uPAR蛋白在淋巴结转移组中的阳性率明显高于无淋巴结转移组(P=0.002,0.008)。PAI-1蛋白在低分化组中的阳性率明显低于中分化和高分化组(P0.05)。uPA,uPAR及VEGF蛋白阳性率在直肠癌组织不同分化程度间差异无显著性。在直肠癌组织中uPA,uPAR蛋白的表达呈显著正相关(r=0.653,P0.001)。在uPA,uPAR蛋白同时阳性的41例病例中，有28例发生淋巴结转移，与阴性组(4/15)相比，转移发生率明显增高(P0.01)。直肠癌组织中uPA蛋白表达与VEGF表达显著正相关(r= 0.300,P0.05)。PAI-1蛋白表达与VEGF表达具有极显著正相关性(r=0.413,P0.01)。应用COX回归模型进行多变量分析并采用向前逐步回归法，仅浸润深度、uPA表达和病理类型对淋巴结转移有影响。结论 uPA,uPAR,PAI-1及VEGF蛋白在直肠癌组织中表达增强，uPA,uPAR与直肠癌浸润转移密切相关。 　　【关键词】 直肠癌；uPA系统；血管内皮生长因子；浸润；转移；免疫组化 　　 　　【Abstract】 Objective To detect the expression of urokinase-type plasminogen activator (uPA),uPA receptor (uPAR),plasminogen activator inhibitor type 1 (PAI-1) and vascular endothelial growth factor (VEGF) in rectal cancer (RC) and to reveal their correlation to the major clinicopathological characteristics including tumor invasion and metastasis.Methods Expression of uPA,uPAR,PAI-1 and VEGF was examined in the tissue sections from 67 cases of RC using streptoavidin-biotin-peroxidase immunohistochemistry method.Results The expression of uPA,uPAR,PAI-1 and VEGF was mainly located in the cytoplasm of RC cells.The expression of uPA,uPAR,PAI-1 and VEGF in RC was significantly higher than in the cancer-adjacent tissue (P0.01).The expression of uPA,uPAR,PAI-1 and VEGF in RC with serosa invasion was significantly higher than that in cancer without serosa invasion (P0.05).Positive rates of staining for uPA and uPAR in GC with lymph node metastasis were significantly higher compared to cancer without lymph node metastasis (P=0.002 and 0.008 respectively).The expression of PAI-1 was significantly associated with the differentiation degree of cancer (P0.01),while no relationship was found between the expression of