【摘要】 目的:观察食管癌组织中VEGF-C的表达水平,探讨其与食管癌淋巴结转移的关系。方法:收集河南省肿瘤医院2000年1月至2009年6月间手术治疗的食管癌病例组织蜡块中资料齐全的检测样本,并摘录相应病历中的诊断信息,应用免疫组织化学SP法检测食管癌组织中VEGF-C的表达水平,观察分析其与淋巴结转移的关系。结果:122例食管癌组织中VEGF-C的阳性表达率为61.48%(75/122),其中鳞癌阳性表达率46.81%(22/47),腺癌VEGF-C阳性表达率为63.41%(26/41),小细胞癌阳性表达率为79.41%(27/34),三者存在显著统计学差异(χ~2=8.95,P<0.01)。有淋巴结转移的阳性表达率为74.29%(52/70),无淋巴结转移的阳性表达率为44.23%(23/52),二者差异有统计学意义(χ~2=11.38,P=0.000 7);Ⅲ期食管癌VEGF-C阳性表达率为76.00%(38/50),明显高于Ⅰ、Ⅱ期食管癌VEGF-C的阳性表达率51.39%(37/72)。VEGF-C的表达与年龄、性别、浸润深度无明显相关性。多因素调整后食管癌组织中VEGF-C阳性表达者发生淋巴结转移的比值比为2.87,95%可信区间为1.28～6.44(χ~2=6.57,P=0.0104)。鳞癌、腺癌、小细胞癌发生淋巴结转移的比值比为1.66,95%可信区间为0.98～2.83(χ~2=3.53,P=0.06)。浸润至外膜的食管癌和浸润至肌层以内的食管癌发生淋巴结转移的比值比为2.21,95%可信区间为0.96～5.10(χ~2=3.45,P=0.06)。结论:VEGF-C阳性表达的食管癌患者发生淋巴结转移的风险高于VEGF-C阴性表达者,VEGF-C的检测可作为判断食管癌淋巴结转移的辅助指标。更多还原

【Abstract】 Objective: To explore the relationship between VEGF-C expression in esophageal cancer and lymph node metastasis. Methods: Paraffin-embeded samples of esophageal cancer in our hospital during January 2000 and June 2009 and the corresponding clinical data were collected. Immunohistochemical SP method was employed to detect VEGF-C expression. The relationship between VEGF-C expression and lymph node metastasis of esophageal cancer was analyzed. Results: The positive rate of VEGF-C expression in 122 tissue samples of esophageal cancer was 61.48% (75/ 122). Among them, the positive rate of VEGF-C expression was 46.81% (22/47) in squamous cell carcinoma, 63.41% (26/ 41) in adenocarcinoma, and 79.41% (27/34) in small cell carcinoma, with a significant difference (P<0.05). The positive rate of VEGF-C expression was 74.29% (52/70) in cases with lymph node metastasis and 44.23% (23/52) in those without lymph node metastasis, with a significant difference (χ~2=11.38, P=0.0007). The positive rate of VEGF-C in stage Ⅲ esophageal cancer was 76% (38/50), higher than that in stage Ⅰ and Ⅱ esophageal cancer [51.39% (37/72)]. There was no significant correlation between VEGF-C and age, sex, or depth of invasion. The odds ratio of lymph node metastasis of patients with positive expression of VEGF-C was 2.87 and the 95% confidence interval was 1.69 to 6.44 (χ~2=4.44, P= 0.0104). The odds ratio of lymph node metastasis of squamous cell carcinoma, adenocarcinoma and small cell carcinoma was 1.66 and the 95% confidence interval was 0.98 to 2.83 (χ~2=3.53, P=0.06). The odds ratio of lymph node metastasis of esophageal cancer with invasion to the adventitia or muscular layer was 2.20 and the 95% confidence interval was 0.96 to 5.10 (χ~2=3.45, P=0.06). Conclusion: Esophageal cancer with positive expression of VEGF-C has higher potential of lymph node metastasis. Detection of VEGF-C is helpful for evaluating lymph node metastasis of esophageal cancer.更多还原