子宫内膜癌组织中微血管密度表达的临床研究_临床医学论文.docVIP

子宫内膜癌组织中微血管密度表达的临床研究_临床医学论文 子宫内膜癌组织中微血管密度表达的临床研究_临床医学论文 【关键词】 子宫内膜癌 　　摘要 :目的 测定子宫内膜癌组织中微血管密度（MVD）表达情况，探讨MVD与子宫内膜癌的临床病理特征、转移、预后的关系。 方法 选取47例子宫内膜癌标本，采用免疫组织化学技术利用Ⅷ因子相关抗原标记癌组织中的血管内皮细胞，高倍镜下计数为MVD。与20例正常子宫内膜标本进行对照。 结果 ①子宫内膜癌组织的MVD值均高于正常子宫内膜（0.01），且绝经后内膜癌患者的MVD高于绝经前患者（0.05）。②MVD与子宫内膜癌患者的年龄、组织学分级、FIGO分期、子宫肌层浸润深度及淋巴结转移相关（0.01、0.05）。③FI-GO分期越晚，MVD越呈高密度表达趋势，两者之间有相关性（0.01），微血管高密度表达患者预后差（0.05）。 结论 MVD与子宫内膜癌恶性程度和浸润转移密切相关，是临床判断预后的重要指标。 　　关键词 :子宫内膜癌;血管生成;微血管密度;免疫组织化学;临床病理因素;预后 　　Abstract:Objective Microvessel density（MVD）was studied to decipher its value in the clinical pathology，metastasis and prognosis of endometrial carcinoma.Methods Microscopic sections from47specimens of endometrial carcinoma were scanned at low magnification to identify areas of top capillary density，and the parallel sections were then stained immunohisto-chemically with a marker for endothelial cells to determine the microvascular density（MVD）in terms of the number of vessels per high-power microscopic field.Twenty samples of normal endometriumwere used for control.Results ①The MVD in en-dometrial carcinoma was higher than in normal endometria（0.01），and was higher after menopause than before menopause（0.05）.②MVD of endometrial carcinoma was significantly correlated with age，tumor grade，surgical stage，myometrial invasion and lymph node matastasis（0.01，0.05）.③As MVD was significantly correlated with surgical stage（0.01），higher level of MVD tended to be related to poor prognosis（0.05）.Conclusion MVD is correlated with tumor malignancy，infiltration and metastasis，and can be used as an important prognosticator of endometrial carcinoma. 　　Key words:endometrial cancer;angiogenesis;microvessel density;clinical pathology;prognosis;immunohistochemistry 　　子宫内膜癌是原发于子宫内膜上皮的恶性肿瘤，近年来发病率有上升趋势，早期内膜癌的治愈率较高，而伴发转移的患者预后极差。由于取材不方便或易误诊为月经不调，子宫内膜癌的早期诊断率往往低于宫颈癌，因此有关子宫内膜癌转移及患者预后的研究依然是内膜癌基础临床研究的重要内容。 　　实体肿瘤的生长和代谢需要持续的血管生长以维持营养供应，血管生成是肿瘤恶性转化、生长和转移的生物学基础与重要环节。将子宫内膜癌接种到鸡绒毛膜尿囊或兔角膜时会诱导血管生成，应用血管介入技术在子宫切除标本中发现内膜癌周围有混乱丰富的血管，均说明子