Prognostic role of tumor necrosis, microvessel density, vascular endothelial growth factor and hypoxia inducible factor-1α in patients with clear cell renal carcinoma after radical nephrectomy in a long term follow-up
Prognostic role of tumor necrosis, microvessel density, vascular endothelial growth factor and hypoxia inducible factor-1α in patients with clear cell renal carcinoma after radical nephrectomy in a long term follow-up
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DOI：
10.1177/039463200802100225
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发表时间：
2008-04-01
影响因子：
3.5
通讯作者：
Muzzonigro, G.
中科院分区：
文献类型：
--
作者：
Minardi, D.;Lucarini, G.;Muzzonigro, G.
血管生成是实体瘤生长、侵袭性进展和转移扩散的关键步骤。我们研究了肿瘤坏死、微血管密度（MVD）、血管内皮生长因子（VEGF）和缺氧诱导因子1 α（HIF-1 α）免疫组化表达在大量接受根治性肾切除术的透明细胞肾癌中的重要性，并评估了其表达在长期随访患者生存方面的预后价值。对50例透明细胞肾细胞癌患者进行了检查。评估患者时考虑的特征包括年龄、肿瘤大小和分级、肿瘤内血管和肾包膜浸润、组织学坏死、组织学标本上的MVD、血管和肿瘤细胞VEGF以及血管、肿瘤细胞质和细胞核HIF-1a表达。所有考虑的参数与患者特异性生存期相关。平均年龄为62.06 ± 6.8岁。中位随访时间为191.66个月，中位生存期为120.86个月。个月21例患者在随访中发生转移。肿瘤坏死、微血管浸润和肾包膜浸润在高分期和高分级肾癌中更容易发生;细胞质HIF-1 α在高分级肾癌中高表达。生存率取决于肿瘤分期和分级、肿瘤内血管浸润和包膜浸润以及肿瘤坏死; MVD也是一个重要的预后因素。VEGF和HIF-1 α与高阶段肿瘤的预后相关，其中VEGF是癌症特异性死亡的最重要的独立预后因素。在我们的研究中考虑的组织学和免疫组化参数可以影响肾癌的复发和生存。
Angiogenesis is a critical step in the growth, invasive progression and metastatic spread of solid tumors. We investigated the importance of tumor necrosis, and microvessel density (MVD), vascular endothelial growth factor (VEGF) and hypoxia inducible factor 1 alpha (HIF-1 alpha) immunohistochemical expression in a large series of clear cell renal carcinomas treated with radical nephrectomy and assessed the prognostic value of their expression in terms of patient survival at long-term followup. Fifty patients with clear cell RCC were examined. The features considered when evaluating the patients were age, tumor size and grade, intratumoral vascular and renal capsula invasion, histological necrosis, and MVD, vascular and tumoral cell VEGF, and vascular, tumoral cytoplasmic and nuclear HIF-1a expression on the histologic specimens. All considered parameters were correlated with patient specific survival. Mean age was 62.06 +/- 6.8 years. Median follow-up was 191.66 months; median survival was 120.86. months. Twenty-one patients developed metastases in the follow-up. Tumor necrosis, microvascular-invasion and renal capsula infiltration are more likely to occur in high stage and grade RCC; cytoplasmic HIF-1 alpha is highly expressed in high grade RCC. Survival is dependent upon tumor stage and grade, the presence of intratumoral vascular invasion and capsular infiltration, and tumor necrosis; MVD also resulted as being an important prognostic factor. VEGF and HIF-1 alpha correlate with prognosis in high stage tumors where VEGF is the most important independent prognostic factor for cancer specific death. The histological and immunohistochemical parameters considered in our study can influence disease recurrence and survival in RCC.