血管生成和非小细胞肺癌预后的相关性研究.docVIP

摘要】 目的 探讨微血管密度 (MVD) 和血管内皮生长因子 (VEGF) 在非小细胞肺癌(NSCLC)中的表达及在NSCLC预后中的价值。方法 运用免疫组织化学方法研究43例NSCLC石蜡切片中MVD和 VEGF 的表达。结果 43例NSCLC石蜡标本中，VEGF阳性率为53.5%(23/43)，且与MVD计数具有相关性。MVD计数与NSCLC组织学分化程度、T NM临床分期、淋巴结转移具有明显相关性。单因素生存分析显示MVD、VEGF阳性表达的NSCLC患者术后生存期(OS)缩短(P0.01);多因素 COX回归分析显示：MVD是NSCLC患者预后的独立预测因子。MVD高表达患者手术后死亡的相对危险度是MVD低表达患者的34.247倍(似然比检验，P0.01)。结论 VEGF 对NSCLC肿瘤的血管生成可能起重要作用;MVD与NSCLC的转移密切相关，可能是较强的独立预后因子，MVD高的NSCLC患者预后不良。 【关键词】 肺肿瘤;微血管密度;血管内皮生长因子 Relationship between angiogenesis and prognosis of nonsmall cell lung cancer 　　HUANG LiNian, XIAO Wei, CHEN YuQing. 　　Department of Respiratory, Shandong University, Jinan 250012, Shandong, China 　　【Abstract】 Objective To investigate the relation between microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression and the value of MVD and VEGF expression in nonsmall cell lung cancer (NSCLC). Methods MVD and VEGF expression in tumor tissue from 43 cases of NSCLC were examined by immunohistochemistry methods. Results The positive expression of VEGF in 43 patients with NSCLC was 53.5%(23/43)，and it was significantly correlated with MVD count. MVD count had obvious relationship with NSCLC histology differentiation, TNM phage, lymphatic metastasis. The positive expressions of VEGF and MVD predicated shorter overall survival (OS). MVD was an independent prognostic factor of clinical outcome in NSCLC by multivariate analyses. The risk ratio of death was 34.247 fold of patients with MVD high expression compared with MVD lower expression (P0.01). Conclusions VEGF might play an important role in NSCLC angiogenesis. MVD is closely correlated with NSCLC metastasis and might be an independent prognostic factor, the higher MVD，the worse prognosis. 　　【Key words】 Lung cancer;Microvessel density;Vascular endothelial growth factor 　 肺癌的预后受多种因素的影响，传统的TNM分期不能完全准确地预测肺癌患者的预后，寻找新的判断预后的生物学指标是目前研究的热点之一。研究发现肿瘤的生长、浸润和转移是一个依赖于血管生成的过程，肿瘤新生血管的形成与肿瘤患者的预后密切相关。血管内皮生长因子(VEGF)是目前公认的肿瘤血管生成最重要的刺激因子，在多种实体肿瘤中存在高表达〔1，2〕。但肿瘤血管生成和血管浸润