【摘要】 目的探讨淋巴管生成及血管生成在不同亚型甲状腺乳头状癌发生转移中的不同作用。方法收集69例甲状腺乳头状癌患者,其中经典甲状腺乳头状癌40例,滤泡型甲状腺乳头状癌29例。采用免疫组化的方法,分别检测VEGF、COX-2及p27^kip1（p27）在肿瘤中的表达,用CD31与D2-40分别标记微血管与淋巴管,分析上述标记物的表达与临床病理因素的关系。结果 VEGF的阳性表达与微血管密度（MVD）及年龄相关的肿瘤直径密切相关（P<0.05）,VEGF与COX-2的共表达与肿瘤的脉管内浸润密切相关（P<0.05）,从肿瘤的淋巴管生成及血管生成分析滤泡型甲状腺乳头状癌的淋巴管密度高于微血管密度（P<0.05）,也高于经典甲状腺乳头癌的淋巴管密度,而经典乳头状癌的微血管密度高于滤泡型乳头状癌,且在经典乳头状癌中VEGF的阳性表达率也高于滤泡型乳头状癌,但在滤泡型乳头状癌中COX-2的表达与p27的表达呈负相关（r=-0.455,P<0.05）,而在经典型乳头状癌中两者无相关性（P>0.05）。结论 VEGF、COX-2及p27在不同亚型甲状腺癌的血管生成及淋巴管生成中起到不同的调控作用。更多还原

【Abstract】 Objective To evaluate the angiogenic and lymphangiogenic functions of papillary thyroid carcinoma（PTC）, considering the differences between histological variants. Methods Angiogenic and lymphangiogenic profiles were analyzed by determining microvascular density（MVD） and lymphatic vessel density（LVD） in 69 cases of PTC using immunohistochemistry. To assess the biological markers involved in blood and lymph vessel formation, the expression of vascular endothelial growth factor（VEGF）, cyclooxygenase 2（COX-2）, and p27^kip1（p27） was determined. Results Positive VEGF expression was strongly associated with high MVD and age-related tumor enlargement（P<0.05）. The presence of vascular invasion was associated with the expression of VEGF and COX-2（P<0.05）. MVD was significantly higher in patients with high-risk PTC and in those with local extrathyroidal and vascular invasion（P<0.05）. The analysis of angiogenesis and lymphangiogenesis in different histological variants of PTC revealed elevated LVD rather than MVD in the follicular variant of PTC. Lower MVD was observed in follicular PTC relative to the classic variant of PTC. The frequency of VEGF-positive tumors was higher in classic PTC than in follicular PTC. A significant negative association between COX-2 and p27 expression was observed in follicular PTC（r=-0.455, P<0.05）, but not in classic PTC. Conclusion These results suggest that VEGF, COX-2, and p27 may play different roles that determine the angiogenic and lymphangiogenic potentials of PTC, particularly between the follicular and classic variants.更多还原