【摘要】 背景:血管内皮生长因子(VEGF)是肿瘤血管再生的重要刺激因子,肿瘤血管再生与众多肿瘤患者预后密切相关。骨肉瘤血管生成与预后的关系如何?目的:研究VEGF对骨肉瘤血管生成、生长、转移及预后的影响。设计:随机对照的实验研究。地点和对象:实验地点:唐都医院全军骨肿瘤研究所。对象:69例骨肉瘤标本。干预:对69例骨肉瘤患者的临床病理资料进行回顾性研究,应用CD34,VEGF单克隆抗体对其组织切片分别进行免疫组化染色,应用地高辛标记的VEGF探针对27例原发性骨肉瘤进行原位杂交染色。分析研究VEGF表达和CD34染色阳性血管密度与患者预后关系。主要观察指标:血管内皮生长因子(VEGF)和微血管密度(MVD)。结果:VEGF阳性表达率为56.5%(39/69),VEGF阳性组肿瘤微血管计数(MVC)(35.7±9.8)及微血管周径(MVP)(2.76±0.18)μm明显高于VEGF阴性组犤MVC(7.2±2.4)及MVP(0.62±0.04)μm犦。多元回归分析显示,血管密度增高及VEGF表达阳性与骨肉瘤患者的远隔转移发生、不良预后密切相关(P<0.05)。临床病理资料中,外科手术边界微小病灶阳性情况、Enneking外科分期、肿瘤大小和患者年龄与患者预后相关(P<0.05)。患者性别、手术方法分类以及病理亚型与预后无相关性。结论:VEGF在骨肉瘤的血管生成和转移中起到重要作用,VEGF是骨肉瘤更多还原

【Abstract】 BACKGROUND:Vascular endothelial growth factor(VEGF) is considered as the most important stimulating factor in angiogenesis of tumor,which is correlated with the prognosis of numerous tumor patients.However,its correlation with osteosarcoma has not been demonstrated. OBJECTIVE:To investigate the effects of VEGF on angiogenesis,growth,metastasis and prognosis in osteosarcoma. DESIGN:A randomized controlled trial study was conducted. SETTING and PARTICIPANTS:The experiment was completed in Institute of Orthopaedic Oncology of Chinese PLA,Tangdu Hospital,Fourth Military Medical University.Subjects were 69 specimens of osteosarcoma. INTERVENTIONS:A retrospective study was undertaken on the clinical pathological data of 69 patients with osteosarcoma.Immunohistochemical staining was performed on the tissue sections by CD34 and VEGF monoclonal antibody,while hybridization in situ staining was performed on 27 cases of original osteosarcoma by VEGF probe,which was tagged by cardiox.The correlation between the expression of VEGF and the density of CD34 positive microvessels,the prognostic significance of VEGF expression,microvascular density(MVD) and clinicopathological variables were analyzed. MAIN OUTCOME MEASURES:VEGF and MVD. RESULTS:The positive expression rate of VEGF was 56.5%(39/69);tumor microvascular count(MVC) and microvascular perimeter(MVP) in VEGF positive group were (35.7±9.8) and (2.76±0.18) μm,which were significantly higher than those in VEGF negative group[MVC(7.2±2.4) and MVP(0.62±0.04) μm](P< 0.05).Multivariate analysis indicated that MVD and VEGF expressions were closely correlated with the patients’ poor prognosis as well as tumor metastasis.In terms of clinicopathological variables,the microscopic margin appearance,Enneking stage,tumor size and patients’ age were correlated with the patients’ prognosis(P< 0.05).The microscopic margin appearance,in particular,had more prognostic significance in predicting metastasis and local relapse.Prognosis was not correlated with patient’s gender,surgical category and pathologic subtype. CONCLUSION:VEGF,a critical angiogenic stimulus that stimulates angiogenesis,plays an important role in growth and metastasis of osteosarcoma.MVD and VEGF expression can function as two independent prognostic variables in osteosarcoma.更多还原