Angiogenesis Predicts Poor Prognosis in Gastric Carcinoma
Angiogenesis Predicts Poor Prognosis in Gastric Carcinoma
复制标题
血管生成预示着胃癌的不良预后
作者：
C. Erenoğlu;M. Akin;H. Uluutku;Levent Tezcan;Ş. Yildirim;A. Batkin
背景/目标：目前正在研究胃癌的新预后因素，以确定疾病的预后或确定哪些患者将受益于辅助治疗。本研究旨在探讨微血管计数（MVC）与胃癌临床病理特征的相关性，以评价血管生成对胃癌预后的影响。方法：回顾性分析1993 ~ 1997年间57例胃癌手术治疗的临床资料。MVC和各种临床病理特征之间的关系进行了评估。通过多因素分析评估血管生成对总生存率的影响以及MVC和其他预后因素对远处转移的作用。采用链霉亲和素-生物素法，通过抗凝血因子VIII（一种针对血管内皮细胞中凝血因子VIII的特异性单克隆抗体）勾画微血管轮廓，并在光学显微镜×200放大倍数下计数。结果：MVC与患者年龄、性别、症状持续时间及肿瘤大小无相关性。近端、未分化、弥漫型、浆膜浸润阳性、淋巴结浸润阳性、晚期或远处转移的肿瘤具有较高的MVC。较高的MVC对总生存率有不利影响。淋巴结转移、浆膜浸润和MVC是影响远处转移的独立预后因素。MVC是影响肝转移复发的唯一因素。总结：结论：胃癌中的MVC可能是一个有价值的预后因素，以预测患者在高风险的可能复发，并决定术后辅助治疗。
Background/Aims: New prognostic factors in gastric carcinoma to determine the prognosis of the disease or to identify patients who will benefit from adjuvant therapy are being researched. The aim of this study is to investigate the correlation between microvessel count (MVC) and various clinicopathologic features in gastric carcinoma in order to evaluate the role of angiogenesis on the prognosis of gastric cancer. Methods: Fifty-seven patients who underwent surgical intervention for gastric carcinoma between 1993 and 1997 were reviewed retrospectively. The relationship between MVC and various clinicopathological features was assessed. The effect of angiogenesis on overall survival and the role of MVC and other prognostic factors on distant metastases were assessed by multivariate analysis. Microvessels were outlined by anti-factor VIII, which is a specific monoclonal antibody to factor VIII in vessel endothelial cells, using the streptavidin-biotin method and counted under light microscopy ×200 magnification. Results: There was no correlation between MVC and age or sex of the patient, duration of symptoms or tumor size. Proximally located, undifferentiated, diffuse type, serosal invasion positive, lymph node invasion positive, advanced stage, or distantly metastasized tumors had higher MVCs. Higher MVCs affected the overall survival adversely. Lymph node metastasis, serosal invasion and MVC were found as independent prognostic factors affecting distant metastases. MVC was the sole factor affecting recurrent liver metastasis. Conclusion: It is concluded that MVC in gastric carcinoma may be a valuable prognostic factor to predict patients at high-risk for possible recurrences and to decide on postoperative adjuvant therapy.