Increased vascular endothelial growth factor and vascular endothelial growth factor-C and decreased NM23 expression associated with microdissemination in the lymph nodes in stage I non-small cell lung cancer
Increased vascular endothelial growth factor and vascular endothelial growth factor-C and decreased NM23 expression associated with microdissemination in the lymph nodes in stage I non-small cell lung cancer
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DOI：
10.1016/s0022-5223(00)70017-1
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发表时间：
2000-04-01
影响因子：
6
通讯作者：
Watanabe, Y
中科院分区：
文献类型：
--
作者：
Ohta, Y;Nozawa, H;Watanabe, Y
目的：我们检查了淋巴结中癌细胞的微播散情况，并评估了其临床和生物学特征。方法：从122例原发性I期肺癌患者中获取原发肿瘤和淋巴结（2030个淋巴结），这些患者接受了根治性手术，对肺门和纵隔淋巴结进行了常规系统性淋巴结清扫。免疫组织化学抗细胞角蛋白染色用于检测癌细胞的淋巴结微播散。还对原发部位的血管内皮生长因子、C 型血管内皮生长因子和 nm23 表达进行了免疫组织化学研究。结果：总共 35 名患者 (29%) 淋巴结中存在细胞角蛋白阳性细胞。原发部位血管内皮生长因子 (P = .0001) 和 C 型血管内皮生长因子 (P < .0001) 表达增加与淋巴结微播散显着相关，nm23 与微播散呈负相关 (P = .008)。淋巴结微播散患者的 3 年和 5 年生存率分别为 57% 和 54%。与无淋巴结微播散的患者的预后（83% 和 76%）相比，其预后明显较差（P = .006）。淋巴结微播散对预后的独立影响尚不清楚，但血管内皮生长因子保留了独立的意义。 结论：所有这些发现使我们得出这样的结论：通过免疫组化抗细胞角蛋白染色检测到的淋巴结中肿瘤细胞的微播散肯定是具有高全身性疾病风险的转移。
Objective: We examined a microdissemination of cancer cells in lymph nodes and assessed its clinical and biologic characteristics,Methods: Both primary tumors and lymph nodes (2030 nodes) were obtained from 122 patients with primary stage I lung cancer who underwent curative operations with routine systematic nodal dissection of both the hilar and the mediastinal nodes. Immunohistochemical anticytokeratin staining was used to detect nodal microdissemination of cancer cells. Vascular endothelial growth factor, vascular endothelial growth factor type C, and nm23 expression at primary sites were also immunohistochemically studied.Results: In total, 35 patients (29%) had cytokeratin-positive cells in lymph nodes. Increased expression of vascular endothelial growth factor (P = .0001) and vascular endothelial growth factor type C (P < .0001) at primary sites were significantly associated with nodal microdissemination, and nm23 was inversely correlated with microdissemination (P = .008), The 3- and 5-year survivals for the patients with nodal microdissemination were 57% and 54%. respectively, which was a significantly worse prognosis as compared with those prognoses (83% and 76%) for the: patients without nodal microdissemination (P = .006). The independent prognostic impact of nodal microdissemination was not clear: however, vascular endothelial growth factor retained independent significance.Conclusion: All of these findings lead us to conclude that the microspread of tumor cells in nodes detected by immunohistochemical anticytokeratin staining is definitely a metastasis with a high risk of systemic disease.