肾透明细胞癌淋巴管新生的临床预后意义

发布时间：2018-11-10 14:02

【摘要】：目的：通过研究D2-40在肾透明细胞癌中的表达来探讨淋巴管新生与肾透明细胞癌患者预后的关系。 方法：研究对象是在石河子大学第一附属医院泌尿外科收集的从2005年1月至2012年10月被诊断为肾透明细胞癌的60位患者。从我院病统科调阅入选患者的病历资料，对研究对象的临床资料进行归纳总结，包括性别、年龄、淋巴结是否清扫、淋巴结转移、远处转移、肿瘤T分期及Fuhrman细胞核分级。在我院病理科调阅60名患者的HE切片，挑选同时具有癌组织和正常组织的石蜡块。通过免疫组织化学染色的方法利用D2-40在淋巴管内皮细胞中的表达来标记60例肾透明细胞癌患者标本中的淋巴管。利用光学显微镜来测定癌周淋巴管密度（peritumoral lymphatic vessels density，PLVD）以及观察癌内淋巴管（intratumoral lymphatic vessels，ILV）是否出现，从而评价PLVD及ILV与临床病理因素的相关性，及其与患者预后的关系。利用SPSS17.0版软件进行数据统计学分析。 结果：所有研究对象的平均PLVD为16.89，将研究对象分为PLVD≥16.89和PLVD＜16.89两组，将PLVD与临床病理因素进行相关性分析。结果表明PLVD与远处转移（P=0.073）、淋巴结转移（P=0.758）、Fuhrman细胞核分级（P=0.866）和肿瘤T分期（P=0.653）无相关性，结果无统计学意义。ILV的出现与远处转移（P=0.001）、淋巴结转移（P=0.017）及Fuhrman细胞核分级（P=0.002）有相关性，与肿瘤T分期（P=0.570）无相关性。生存分析显示PLVD≥16.89组总体生存率是34.9%，中位生成时间是52±9个月，PLVD＜16.89组总体生存率是42.30%，中位生成时间是71±20个月，相比较两组的生存率无统计学意义（P=0.223）；ILV阳性组的总体生存率是17.50%，中位生成时间是26±3个月，ILV阴性组的总体生存率是46.00%，中位生成时间是71个月，相比较结果有统计学意义（P=0.000）。多因素Cox回归分析表明肿瘤T分期和ILVs是肾透明细胞癌患者的独立预后因素，P值分别是0.006和0.001。 结论：D2-40在淋巴管高表达，，对于血管则不表达，能清晰的区分淋巴管和血管。癌周淋巴管新生对患者的预后可能无影响；癌内淋巴管新生对患者的预后可能有不良影响。多因素分析表明在不考虑淋巴结转移的情况下，肿瘤T分期及ILVs是肾透明细胞癌患者的独立预后因素。
[Abstract]:Aim: to investigate the relationship between lymphangiogenesis and prognosis of renal clear cell carcinoma (RCC) by investigating the expression of D 2-40 in renal clear cell carcinoma (RCC). Methods: sixty patients with clear cell carcinoma of kidney were collected from urology department of the first affiliated Hospital of Shihezi University from January 2005 to October 2012. The clinical data of selected patients were reviewed from the Department of Disease and Statistics of our hospital. The clinical data including sex age lymph node dissection lymph node metastasis distant metastasis tumor T stage and Fuhrman nuclear grading were summarized. The HE sections of 60 patients were collected from the pathology department of our hospital, and paraffin lumps with both cancerous and normal tissues were selected. The expression of D2-40 in lymphatic endothelial cells was used to label the lymphatic vessels in 60 cases of renal clear cell carcinoma by immunohistochemical staining. In order to evaluate the correlation between PLVD and ILV and clinicopathological factors, the relationship between PLVD and ILV and the prognosis of patients were evaluated by using optical microscope to determine the density of lymphatic vessels (peritumoral lymphatic vessels density,PLVD) around carcinoma and to observe the presence of intratumoral lymphatic (intratumoral lymphatic vessels,ILV. Use SPSS17.0 software for statistical analysis of data. Results: the average PLVD of all subjects was 16.89. The subjects were divided into two groups: PLVD 鈮

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