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目的检测尿激酶纤溶酶原激活剂(uPA)在下咽鳞状细胞癌组织及癌旁正常黏膜中的表达以及CD34抗体标志的微血管密度(MVD)的差异,探讨其与下咽癌侵袭转移的关系。方法应用免疫组织化学SP法检测60例下咽癌组织及20例下咽部癌旁正常黏膜组织中uPA蛋白的表达及以CD34抗体标志的微血管密度。结果 uPA蛋白在下咽鳞癌组织中的表达率为78.33%(47/60),明显高于癌旁正常黏膜组织中的表达(P<0.001),uPA蛋白的表达与其临床分期、病理分化程度及淋巴结转移呈显著相关关系(P<0.05);MVD计数与肿瘤的临床分期、病理分化程度及淋巴结转移呈显著相关关系(P<0.05或0.01);两者与患者发病年龄及肿瘤原发解剖分区均无明显相关性;下咽癌组织中MVD计数与uPA的阳性表达呈正相关关系(r=0.561,P<0.01);uPA阳性并MVD高表达组的淋巴结转移率为90.91%(20/22),明显高于uPA阳性并MVD低表达组(52.00%)及uPA阴性MVD低表达组(30.77%)(2χ=9.538,P<0.05)。结论 uPA蛋白的高表达促进了肿瘤新生血管的生成,活跃的新生血管生成和uPA蛋白的高表达与下咽癌的侵袭及颈部淋巴结转移密切相关,uPA高表达且MVD计数高的下咽癌患者发生肿瘤浸润及颈淋巴结转移的风险明显增高。uPA的表达强度及MVD的计数值可作为判断下咽鳞状细胞癌生长、浸润及转移能力的重要指标。
Objective To detect the expression of urokinase plasminogen activator (uPA) in the squamous cell carcinoma of the hypopharynx and its adjacent normal mucosa, and the difference of microvessel density (MVD) between the expression of CD34 antibody and invasive umbilical carcinoma relationship. Methods Immunohistochemical SP method was used to detect the expression of uPA protein in 60 cases of hypopharyngeal carcinoma tissue and 20 cases of adjacent normal mucosa adjacent to hypopharynx. The density of microvessels marked by CD34 antibody was detected. Results The expression of uPA protein in squamous cell carcinoma of the hypopharyngeal squamous cell carcinoma was 78.33% (47/60), which was significantly higher than that in normal mucosa (P <0.001). The expression of uPA protein was correlated with clinical stage, pathological differentiation, Lymph node metastasis (P <0.05). There was a significant correlation between the MVD count and clinical stage, pathological differentiation and lymph node metastasis (P <0.05 or 0.01). Both of them correlated with the age of onset and primary anatomy of the tumor (R = 0.561, P <0.01). The lymph node metastasis rate of uPA positive and MVD high expression group was 90.91% (20/22) , Which was significantly higher than that of uPA positive and MVD low expression group (52.00%) and uPA negative MVD low expression group (30.77%) (2χ = 9.538, P <0.05). Conclusion The high expression of uPA protein promotes the formation of neovascularization of tumor. The expression of active neovascularization and uPA protein is closely related to the invasion of hypopharyngeal carcinoma and cervical lymph node metastasis. The expression of uPA protein is high in hypopharyngeal carcinoma with high MVD Patients with tumor invasion and cervical lymph node metastasis significantly increased the risk. The expression of uPA and the count of MVD can be used as an important index to judge the growth, invasion and metastasis of hypopharyngeal squamous cell carcinoma.