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目的:探讨胰腺癌组织中血管内皮生长因子C(vascular endothelial growth factor-C,VEGF-C)、血管内皮生长因子D(vascular endothelial growth factor-D,VEGF-D)与微淋巴管密度(microvessel vessd density,MLVD)、微血管密度(microvessel density,MVD)及淋巴结转移之间的相关关系,阐明癌周淋巴管增生的机制及意义。方法:免疫组化检测30例胰腺癌组织中VEGF-C、VEGF-D、血管内皮生长因子受体3(vascular endothelialg rowth factor receptor-3,VEGFR-3)(MLVD)以及CD34(MVD)蛋白的表达,RT-PCR检测VEGF-A、VEGF-C、VEGF-DmRNA在30例胰腺癌新鲜组织中的表达。结果:VEGF-C、VEGF-D蛋白阳性率分别为73%(22/30)和57%(17/30),肿瘤周边部位显著高于肿瘤中心部位,差异有统计学意义,P<0·05;其表达与肿瘤的部位、分化程度以及组织学类型无关,而与肿瘤的TNM分期有关,Ⅲ、Ⅳ期显著高于Ⅰ、Ⅱ期。在VEGF-C蛋白阳性组,MVD高于阴性组,P=0·0472,MLVD亦高于阴性组,P<0·01,淋巴结转移增多,P=0·0318;VEGF-D蛋白阳性组与阴性组相比MVD无变化,P=0·07,MLVD高于阴性组,P<0·01,淋巴结转移增加,P=0·0179。结论:VEGF-C参与胰腺癌血管生成和淋巴管生成的调控,VEGF-D只参与淋巴管生成的调控。VEGF-C和VEGF-D诱导胰腺癌淋巴管生成,促进肿瘤细胞淋巴道转移。
Objective: To investigate the expression of vascular endothelial growth factor-C (VEGF-C), vascular endothelial growth factor-D (VEGF-D) and microvessel vessd density, MLVD), microvessel density (MVD) and lymph node metastasis, to elucidate the mechanism and significance of lymphangiogenesis in cancer. Methods: The expressions of VEGF-C, VEGF-D, vascular endothelial growth factor receptor-3 (MLVD) and CD34 (MVD) in 30 pancreatic cancer tissues The expression of VEGF-A, VEGF-C and VEGF-D mRNA in 30 fresh pancreatic cancer tissues was detected by RT-PCR. Results: The positive rates of VEGF-C and VEGF-D protein were 73% (22/30) and 57% (17/30), respectively. The peripheral area of the tumor was significantly higher than that of the tumor center, the difference was statistically significant, P <0. 05; its expression was not related to tumor location, differentiation and histological type, but was related to tumor TNM stage. The stage Ⅲ and Ⅳ were significantly higher than stage Ⅰ and Ⅱ. In the positive VEGF-C group, the MVD was higher than that in the negative group (P = 0.0472). The MLVD was also higher than that in the negative group, P <0.01, lymph node metastasis increased, P = 0.0318; MVD in the negative group did not change, P = 0 · 07, MLVD higher than the negative group, P <0.01, lymph node metastasis increased, P = 0.0179. Conclusion: VEGF-C is involved in the regulation of angiogenesis and lymphangiogenesis in pancreatic cancer. VEGF-D is only involved in the regulation of lymphangiogenesis. VEGF-C and VEGF-D induce lymphangiogenesis in pancreatic cancer and promote lymphatic metastasis of tumor cells.