Immunohistochemical evaluation of the tumor neoangiogenesis as a prognostic factor for gastric cancers.
Immunohistochemical evaluation of the tumor neoangiogenesis as a prognostic factor for gastric cancers.
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发表时间：
2008
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通讯作者：
D. Lazăr;S. Tăban;Marius Raica;I. Sporea;M. Cornianu;A. Goldiş;C. Vernic
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作者：
D. Lazăr;S. Tăban;Marius Raica;I. Sporea;M. Cornianu;A. Goldiş;C. Vernic
血管生成是新血管形成的过程，在恶性细胞的存活、局部扩张和肿瘤侵袭以及远处转移的出现中起着至关重要的作用。材料与方法探讨胃癌患者MVD、VEGF表达及临床病理因素与生存期的关系。本研究对胃癌的演变和侵袭性进行了前瞻性研究，为期5年，纳入61例胃癌手术患者。研究组所有胃癌病例均行CD34和VEGF免疫组化反应。结果胃癌中MVD的平均值明显高于正常粘膜（38.7比12.5,p<0.001）。在肠型中，我们注意到平均MVD远低于弥漫性胃癌的平均MVD(36.8比41.6)（p=0.02478 S）。间变性癌和印戒细胞癌作为一种与强烈的新生血管生成活动相关的组织学形式正在分离。新生血管生成活性与组织学分级、淋巴血管侵袭程度、扩展程度、淋巴结转移、远处转移及TNM分期有关。VEGF阳性免疫反应在胃癌中明显高于正常胃黏膜（65.6% vs. 6.5%, p<0.001 ES）。VEGF蛋白免疫反应阳性率为71.1%，明显高于弥漫性癌（52.9%）（p=0.018178 S）。我们的研究结果表明，组织学分级、肿瘤侵袭程度与VEGF表达密切相关。结论VEGF表达与胃癌患者5年生存率有显著相关性，VEGF +~++组生存率明显低于VEGF阴性组（12.5% vs. 23.8%） （p=0.027983 S）。我们的研究证实了VEGF的表达与MVD的密切相关（p=0.03986 S），这些因素在肿瘤的生物学行为、进展和预后中起着重要作用。
INTRODUCTION The angiogenesis, the process by which new blood vessels are formed, plays an essential role in the survival of the malignant cells, in the local expansion and tumor invasion, as well as in the appearance of distant metastases. MATERIAL AND METHODS We evaluated the relation between MVD, the VEGF expression, the clinicopathologic factors and the survival in patients with gastric cancer. A prospective study has been carried out, regarding the evolution and aggressiveness of the gastric cancer, with a duration of 5 years, 61 patients that underwent a surgery for gastric cancer being included in the study. The immunohistochemical reactions for CD34 and VEGF were performed for all gastric cancers cases included in the study group. RESULTS MVD has shown in the gastric carcinomas an average value significantly higher in comparison to the normal mucosa (38.7 vs. 12.5, p<0.001 ES). In the intestinal type we have noticed a much lower average MVD than the average MVD in the diffuse type of gastric carcinomas (36.8 vs. 41.6) (p=0.02478 S). The anaplastic carcinoma and the signet ring cell carcinoma are detaching themselves as histological forms associated to an intense neoangiogenesis activity. The neoangiogenesis activity is correlated with: the histologic grade, the lymphovascular invasion, the level of extend, the lymph node metastasizing, the distant metastasizing and the TNM stage. The positive immunoreactions for VEGF are significantly more frequent in the gastric carcinomas, in comparison to the normal gastric mucosa (65.6% vs. 6.5%, p<0.001 ES). The immunoreactions to the VEGF protein were positive in 71.1% of the intestinal carcinomas, significantly more frequent in comparison to the diffuse type carcinomas (52.9%) (p=0.018178 S). Our results show a tight correlation between the histologic grade, the level of the tumor invasion and the VEGF expression. CONCLUSIONS Our results prove the major correlation between the VEGF expression and the 5-year survival rate of the patients with gastric cancer, the survival rate for the carcinomas with VEGF +~++ being significantly lower than for the VEGF negative ones (12.5% vs. 23.8%) (p=0.027983 S). Our study proves a tight correlation between the VEGF expression and the MVD (p=0.03986 S), these factors playing an important role in the tumoral biologic conduct, in the progression and the prognostic.