Association of color Doppler vascularity index and microvessel density with survival in patients with gastric cancer
Association of color Doppler vascularity index and microvessel density with survival in patients with gastric cancer
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DOI：
10.1097/00000658-200204000-00009
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发表时间：
2002-04-01
影响因子：
9
通讯作者：
Chang, KJ
中科院分区：
文献类型：
--
作者：
Chen, CN;Cheng, YM;Chang, KJ
目的 本研究的目的是探讨微血管密度（MVD）和体内血管生成参数彩色多普勒血管分布指数（CDVI）在胃癌患者中的临床实用性。 摘要背景数据许多研究报道，MVD 评估的血管生成程度与各种实体瘤患者的临床病理因素和预后之间存在显着相关性。所有这些研究都是在从手术标本中回顾性获得的组织切片上完成的。然而，为了诊断目的、治疗计划和随访，非常需要一种评估人类恶性肿瘤肿瘤血管生成的体内方法。 CDVI是评价体内血管生成的新超声参数，与宫颈癌淋巴结转移状况有良好的相关性，可以预测结肠癌患者的远处转移和生存情况。因此，CDVI也可能有助于评估人胃癌的体内血管生成。方法本研究共纳入79例胃癌患者，通过抗CD-34抗体对手术标本进行免疫组化染色来评估微血管密度。 31 名患者的超声检查可见肿瘤。使用经腹彩色多普勒超声确定每个肿瘤的 CDVI。 CDVI定义为肿瘤切片内彩色像素数与该特定肿瘤切片内总像素数的比值，并使用Encomate软件（台湾台北市工商机器有限公司）计算，研究MVD、CDVI与临床病理因素和患者生存率的相关性。结果MVD与血管显着相关 通过多元线性回归分析入侵。尽管通过单变量分析，高MVD（> 32）患者的生存率显着差于低MVD（< 32）患者，但根据Cox比例风险模型，血管侵犯是独立的预后因素，CDVI与MVD之间存在线性相关（r = .495，P = .005）。此外，在高CDVI（> 11%）的患者中，生存率显着低于低CDVI（小于或等于11 P = .005）的患者。高CDVI（>11%）的患者在根治性切除后2年均无生存，CDVI是III期胃癌患者除血管侵犯外的另一个独立预后因素。结论血管侵犯是胃癌的重要预后指标。高CDVI是III期胃癌患者早期死亡的良好术前指标，因此，CDVI可能有助于选择胃癌患者进行新辅助化疗和/或抗血管生成治疗。
Objective The purpose of this study was to investigate the clinical usefulness of microvessel density (MVD) and an in vivo angiogenesis parameter, color Doppler vascularity index (CDVI), in patients with gastric cancer.Summary Background Data Many studies have reported a significant association between the degree of MVD-evaluated angiogenesis with the clinicopathologic factors and prognosis of patients with various solid tumors. All these studies were accomplished on tissue sections retrospectively obtained from surgical specimens. However, an in vivo method to assess tumor angiogenesis for human malignancies is highly desirable for diagnostic purpose, treatment planning, and follow-up. The CDVI is a new ultrasound parameter for evaluating in vivo angiogenesis, has a good correlation with status of lymph node metastasis in cervical carcinoma, and can predict distant metastasis and survival in colon cancer patients. Therefore, the CDVI may also be useful to assess in vivo angiogenesis in human gastric cancer.Methods A total of 79 patients with gastric cancer were enrolled in this study, and microvessel density was evaluated by using immunohistochemical staining of surgical specimens with anti-CD-34 antibody. Tumors were sonographically visible in 31 patients. The CDVI of each tumor was determined using transabdominal color Doppler ultrasound. The CDVI was defined as the ratio of the number of the colored pixels within a tumor section to the number of total pixels in that specific tumor section, and was calculated by using Encomate software (Electronic Business Machine Co. Ltd., Taipei, Taiwan), Correlation between MVD, CDVI and clinicopathologic factors and patient survival was studied.Results The MVD was significantly correlated with vascular invasion by multiple linear regression analysis. Although the survival of patients with high MVD (> 32) was significantly worse than those with low MVD (< 32) by univariate analysis, vascular invasion was an independent prognostic factor by Cox proportional hazard model, There was a linear correlation between CDVI and MVD (r = .495, P = .005). Moreover, in patients with a high CDVI (> 11%), the survival rate was significantly lower than that in those with low CDVI (less than or equal to 11 P = .005). None of the patients with high CDVI (> 11 %) survived 2 years after curative resection, In addition to vascular invasion, the CDVI was another independent prognostic factor in the patients with stage III gastric cancer.Conclusions Vascular invasion was an important prognostic indicator in gastric cancer. The high CDVI was a good preoperative indicator of early death in stage III gastric cancer patients, Thus, the CDVI may be helpful in selecting patients with gastric cancer for neo-adjuvant chemotherapy and/or anti-angiogenic therapy.