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目的研究血管内皮生长因子D(VEGF-D)在大肠癌中的表达,探讨其表达水平与大肠癌临床病理特征、微血管密度(MVD)及预后的关系。方法抽取1996年1月至1998年1月于瑞金医院外科行结直肠癌根治术且接受正规随访的大肠癌病例69例;所有病例术后第1、2年每3个月、第3年每6个月、第4年后每年1次接受门诊随访,包括体格检查、血清癌胚抗原(CEA)检测、胸片、肝脏B超、腹部CT等。采用免疫组织化学技术检测VEGF—D在69例大肠癌及20例正常大肠组织的表达;采用抗CD34免疫组织化学技术评价大肠癌MVD;采用Axioplan 2 imaging显微图像分析系统对免疫组织化学染色结果进行定量。结果所有(69／69)大肠癌组织和25%(5／20)正常大肠组织检测到VEGF-D表达,染色定位于肿瘤细胞浆。VEGF-D表达显著高于相应正常大肠组织 (P<0．01);VEGF—D表达与大肠癌患者年龄(≤68岁;>68岁)、淋巴结转移及肿瘤浸润深度显著相关(P<0．05);VEGF-D表达与大肠癌患者性别、远处转移、临床分期、分化程度及肿瘤部位相关性均无统计学意义。VEGF—D表达与大肠癌MVD显著相关(P<0．05);VEGF-D高表达的大肠癌患者组总生存期和无瘤生存期显著低于VEGF—D低表达患者组(P<0．05)。结论 VEGF—D在大肠癌中有异常高表达,且与无瘤生存与总生存率显著相关,可用于判断大肠癌预后。
Objective To investigate the expression of vascular endothelial growth factor D (VEGF-D) in colorectal carcinoma and to investigate its relationship with clinicopathological characteristics, microvessel density (MVD) and prognosis in colorectal cancer. Methods A total of 69 cases of colorectal cancer undergoing radical resection of colorectal cancer at Ruijin Hospital from January 1996 to January 1998 were enrolled in this study. All cases were followed up for 1 year, 2 years, every 3 months and 3 years 6 months, 4 years after the annual outpatient visits once a year, including physical examination, serum carcinoembryonic antigen (CEA) detection, chest radiograph, liver B ultrasound, abdominal CT. Immunohistochemistry was used to detect the expression of VEGF-D in 69 cases of colorectal carcinoma and 20 cases of normal colorectal tissues. The anti-CD34 immunohistochemical method was used to evaluate the MVD of colorectal cancer. The Axioplan 2 imaging microscope was used to analyze the immunohistochemistry results Quantitative. Results The expression of VEGF-D was detected in all (69/69) colorectal cancer tissues and 25% (5/20) normal colorectal tissues, and the staining was localized in the cytoplasm of the tumor. The expression of VEGF-D was significantly higher than that of normal colorectal tissue (P <0.01). The expression of VEGF-D was significantly associated with the age of patients with colorectal cancer (≤68years old> 68years), lymph node metastasis and depth of tumor invasion .05). The expression of VEGF-D was not related to the gender, distant metastasis, clinical stage, differentiation and tumor location in patients with colorectal cancer. The expression of VEGF-D was significantly correlated with the MVD of colorectal cancer (P <0.05). The overall survival and tumor-free survival of patients with VEGF-D overexpression were significantly lower than those with low VEGF-D expression .05). Conclusion VEGF-D is highly expressed in colorectal cancer, and is significantly associated with tumor-free survival and overall survival, which can be used to determine the prognosis of colorectal cancer.