【作者】 李中信； 曹雷； 贾漪涛； 杨会钗； 于跃明； 马洪骏；

【Author】 Li Zhong-Xin Cao Lei Jia Yi-Tao Yang Hui-Chai Yu Yue-Ming Ma Hong-Jun The Fourth Hospital of Hebei medical university & Hebei provincial tumor hospital, Shijiazhuang, 050011, China

【机构】 河北医科大学第四医院暨河北省肿瘤医院；

【摘要】 目的:近年来结直肠癌的发病率呈上升趋势,手术仍是其主要治疗手段,但近半数患者术后发生局部复发和淋巴结转移,5年生存率并没有明显提高。由于缺乏特异的淋巴管标志物,有关V E G F—C与肿瘤淋巴管新生 (lymphangiogenesis)的研究很少。本研究旨在探讨脉管内皮生长因子-C(Vascular Endothelial Growth Factor—C) 表达与结直肠癌淋巴管新生、淋巴结转移的关系。方法:采用酶组织化学(5-Nase-ALPase双重染色技术)及免疫组织化学方法,以5-Nase作为淋巴管标志物,检测56例结直肠癌、5例结直肠腺瘤和10例正常结直肠黏膜中的淋巴管新生及VEGF-C表达。利用SPSS10．0软件,采用t检验和x2检验进行统计分析,p<0．05为差异有统计学意义。结果:正常黏膜及黏膜下可见少量淋巴管及血管,平行排列,分布规则。结直肠腺瘤血管明显增多,淋巴管无增多及扩张。结直肠癌及癌旁组织中可见大量新生的淋巴管及血管,肿瘤内部淋巴管多呈条索状,周边部淋巴管多明显扩张,管壁薄,形态不规则。部分平滑肌及组织细胞呈5’-Nase弱阳性反应。 VEGF—C在正常黏膜中无表达,3例结直肠腺瘤不典型增生细胞有VEGF-C表达,41例(74．1％)结直肠癌VEGF-C 表达阳性。VEGF-C表达与结直肠癌淋巴管计数、淋巴结转移密切相关(P<0．05)。与患者性别年龄肿瘤大小分化程度浸润深度无关。结论:结直肠癌中VEGF-C高表达可以诱导淋巴管新生,促进肿瘤周边淋巴管扩张,为结直肠癌向淋巴管转移提供条件,有望成为判断结直肠癌预后的一个有效指标。更多还原

【Abstract】 Objective: Colorectal cancer is a common cause of death throughout the world including China. The effect of treatment is still unsatisfied because of the local recurrence and lymph node metastasis. The aims of this study is to investigate the relationship between VEGF-C expression,lymphangiogenesis and lymphatic metastasis in human colorectal cancer. Methods: Enzymehistochemistry(5’ -Nase-ALPase double staining) and immunohistochemistry were used, and 5’ -Nase was acted as the marker of lymphatic vessels. 56 cases of human colorectal carcinomas, 5 cases of adenomas and 10 cases normal mucosa were detected.The data were analysed by t test and x2 test. Allreported P value were two-sides, and P<0.05 was considered statistically significant. Results: Lymphatic vessels were 5’ -Nase positive(brown)and blood vessels were ALPase positive (blue). The most lymphatic vessels were enlarged and dilated especially in peritumor areas. No VEGF-C expression was detected in normal mucosa, and VEGF-C was expressed in atypical hyperplasia cells of 3 cases of adenomas and 41cases (74.1%) of carcinomas. A positive association of VEGF-C expression and lymphatic metastasis was demonstrated (P<0.05).While no significant correlation with gender, age, tumor size, degree of differentiation, depth of invasion and TNM stage. Conclusion: VEGF-C induced lymphangiogenesis in human colorectal carcinoma, and promoted cancer cells invading to these lymphatic vessels. It might be a useful index for prognosis.更多还原