VEGF-C表达及微淋巴管密度与黑色素瘤淋巴转移的相关性研究

发布时间：2018-01-27 22:34

本文关键词： 黑色素瘤血管内皮生长因子C 微淋巴管密度无转移生存率　出处：《南京医科大学》2010年硕士论文　论文类型：学位论文

【摘要】：目的:探讨血管内皮生长因子C(VEGF-C)和淋巴管内皮特异性标志物D2-40标记的微淋巴管密度在人类黑色素瘤中的表达,分析VEGF-C、微淋巴管密度与淋巴结转移等黑色素瘤临床及病理特点的联系,以及VEGF-C的表达和微淋巴管密度的相关性,为黑色素瘤的转移和预后判定提供一定的理论依据。方法:收集我院2003年1月至2009年6月之间手术切除的原发性黑瘤标本24例。另选取11例黑色素痣作为对照。应用免疫组织化学EnVision二步法观察24例黑瘤组织中VEGF-C和D2-40的表达,对D2-40阳性脉管进行微淋巴管密度计数,分析VEGF-C和微淋巴管密度与黑瘤的临床、病理特点之间的关系,以及VEGF-C和微淋巴管密度的相关性。结合随访资料进行生存分析,分别评价VEGF-C和微淋巴管密度对黑瘤患者无转移生存率的影响。结果:(1)微淋巴管密度在黑瘤组和黑痣组中分别为14.30±4.91和7.64±3.08,两者有非常显著性差异(P0.01)。(2)黑瘤组织中微淋巴管密度计数在不同年龄、性别、Breslow分层、Clark分级、脉管侵犯各组之间差异均无统计学意义(P0.05)。而溃疡组肿瘤微淋巴管密度较无溃疡组高(P=0.005)。(3)黑瘤组织中VEGF-C蛋白的阳性表达率100%。其中“+”占20.8%(5/24),“++”占33.4%(8/24),“+++”占45.8%(11/24)。VEGF-C蛋白在不同年龄、性别、Clark分级、Breslow分层、溃疡、脉管侵犯各组的阳性表达差异均无统计学意义(P0.05)。(4)黑瘤中VEGF-C蛋白弱、中阳性表达组的微淋巴管密度低于强阳性表达组的微淋巴管密度。但spearman等级相关分析显示VEGF-C蛋白表达与微淋巴管密度之间无相关性(r=0.278,P=0.188)。(5)生存分析显示,微淋巴管密度大于或等于14.7的黑瘤患者的无转移生存率较微淋巴管密度小于14.7个的患者低(χ2=3.891,P=0.049)。未发现VEGF-C蛋白表达对黑瘤患者的无淋巴转移生存率有影响(P0.05)。结论:(1)D2-40对淋巴管内皮特异性和敏感性较好,可以用于肿瘤淋巴管生成的研究。在分析与转移有关的影响因素时,预后指标可以选择无转移生存率。(2)微淋巴管密度和肿瘤表面有无溃疡正有关。(3)黑瘤组织中微淋巴管密度明显高于黑痣,淋巴管生成可能与黑瘤的发生有关。未发现黑瘤组织中VEGF-C蛋白表达与微淋巴管密度有相关性。(4)黑瘤微淋巴管密度和淋巴结转移相关,瘤内淋巴管生成可能是黑瘤淋巴结转移的重要因素,其具体机制仍需深入研究,微淋巴管密度有望成为预测黑瘤淋巴转移及预后的重要指标
[Abstract]:Objective: to investigate the expression of vascular endothelial growth factor (VEGF-C) and lymphatic endothelium-specific marker D2-40 in human melanoma and analyze the expression of VEGF-C. The relationship between microlymphatic vessel density and clinical and pathological features of melanoma such as lymph node metastasis, and the correlation between VEGF-C expression and microlymphatic vessel density. To provide certain theoretical basis for metastasis and prognosis of melanoma. Methods:. Twenty-four cases of primary melanoma were surgically resected from January 2003 to June 2009 in our hospital. Another 11 cases of nevus melanoma were selected as control. Immunohistochemical EnVision was used for two steps. Methods the expression of VEGF-C and D2-40 in 24 cases of melanoma was observed. The microlymphatic vessel density of D2-40 positive vessels was counted, and the relationship between VEGF-C, microlymphatic vessel density and the clinical and pathological characteristics of melanoma was analyzed. The relationship between VEGF-C and microlymphatic vessel density and survival analysis were performed to evaluate the influence of VEGF-C and microlymphatic vessel density on metastasis free survival rate in melanoma patients. Results the density of microlymphatic vessels in melanoma group and nevus group were 14.30 卤4.91 and 7.64 卤3.08, respectively. There was a very significant difference between the two groups (P < 0.01) the number of microlymphatic vessel density in melanoma tissue was different in age, sex, sex, Breslow stratification and Clark grade. There was no significant difference in vascular invasion between each group (P 0.05), but the density of microlymphatic vessels in ulcer group was higher than that in non-ulcer group. The positive expression rate of VEGF-C protein in melanoma tissues was 100%. "33.4% / 24%," "45.88% 11 / 24% .VEGF-C protein at different ages, gender / gender / Clark grade." There was no significant difference in the positive expression of Breslow, ulcer and vascular invasion in all groups. There was no significant difference in the expression of VEGF-C protein in melanoma. The density of microlymphatic vessels in medium positive expression group was lower than that in strong positive expression group, but there was no correlation between VEGF-C protein expression and microlymphatic vessel density in spearman grade correlation analysis. Rn 0.278. The survival analysis showed that. The metastasis-free survival rate of melanoma patients with microlymphatic density greater than or equal to 14.7 was lower than that of patients with microlymphatic vessel density less than 14.7 (蠂 2 = 3.891). It was found that the expression of VEGF-C protein had no effect on the survival rate of patients with melanoma without lymphatic metastasis. Conclusion the specificity and sensitivity of D2-40 to lymphatic endothelium are good, which can be used in the study of lymphangiogenesis in tumor. Prognostic index: metastasis-free survival rate. 2) the density of microlymphatic vessels in melanoma tissue was significantly higher than that in nevus nigra. The density of microlymphatic vessels was positively related to the presence of ulcers on the surface of the tumor. Lymphangiogenesis may be related to the occurrence of melanoma. There was no correlation between the expression of VEGF-C protein and microlymphatic vessel density in melanoma tissues. Lymphangiogenesis may be an important factor in lymph node metastasis of melanoma, and its specific mechanism needs further study. Microlymphatic vessel density is expected to be an important index to predict lymphatic metastasis and prognosis of melanoma.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R739.5

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