鼻咽癌新生脉管及其临床病理意义

发布时间：2018-04-09 16:40

本文选题：D2-40　切入点：CD34　出处：《桂林医学院》2010年硕士论文

【摘要】：目的D2-40是淋巴管内皮细胞的一种高度特异性标志,可用于识别正常和肿瘤组织中的淋巴管,而CD34是新生血管的主要特异标志。肿瘤中高表达VEGF-C可能促进血管和淋巴管新生。我们应用免疫组织化学技术检测鼻咽癌组织中淋巴管特异性标志物D2-40、CD34、VEGF-C和VEGFR-3蛋白的表达,同时测定淋巴管密度和微血管密度,分析它们之间相互关系及与鼻咽癌淋巴结转移的关系。方法选取桂林医学院附属医院2004年6月—2006年9月临床病理资料完整的鼻咽癌活检标本(蜡块包埋)61例,并取30例同期就诊于该医院被病理诊断为轻度鼻咽粘膜炎症鼻咽组织(蜡块包埋)作为对照。采用淋巴管内皮特异性标记物商品化试剂D2-40单克隆抗体、血管内皮细胞特异性标记物CD34单克隆抗体,基于免疫组织化学Supervision法分别检测上述组织标本对D2-40及CD34的表达,测定淋巴管密度(LVD)和微血管密度(MVD);并应用VEGF-C和VEGFR-3商品化试剂盒分别测定该两分子的蛋白表达,以SPSS11.5软件将检测的上述参数与患者各项临床病理指标进行统计学分析。结果1.D2-40在鼻咽癌的组织中呈不同程度表达,淋巴结转移的鼻咽癌组织LVD显著高于无淋巴结转移组(11.01±2.99 V.S 8.83±1.78 P0.05),且鼻咽癌LVD与淋巴结转移呈密切。鼻咽癌瘤周LVD显著高于瘤内(10.34±2.98 V.S 6.25±2.32 P0.05),瘤周LVD计数与淋巴结转移存在密切关系。LVD的计数在鼻咽癌不同年龄、性别、T分期(T_(1-2) V.S T_(3-4))及其临床分期之间的差异均无统计学意义。 2. VEGF-C在鼻咽癌组织中阳性表达率为68.85%。VEGF-C不同表达程度分组之间的瘤周LVD计数差异有统计学意义,两者之间存在密切关系(10.45±4.99 V.S 7.01±2.99 P0.05)。VEGF-C的表达在临床分期(I-II V.S III-IV)的比较有统计学意义,VEGF-C表达在鼻咽癌不同年龄、性别、T分期的差异均无统计学意义。 3.VEGFR-3在鼻咽癌组织细胞膜及胞浆中表达,而在正常鼻咽组织中无表达。存在淋巴结转移的鼻咽癌组织表达VEGFR-3阳性率和无淋巴结转移的鼻咽癌VEGFR-3阳性率比较具有统计学意义(11.69±4.58 V.S 6.68±2.53 P0.05)。VEGFR-3表达在不同临床分期(I-II V.S III-IV)的比较有统计学意义(3/15 V.S 35/46 P0.05),在不同年龄、性别、T分期之间的差异均无统计学意义。 4.CD34在鼻咽癌组织和正常鼻咽组织中有不同程度表达,鼻咽癌组织中MVD显著高于鼻咽正常组织,存在淋巴结转移的鼻咽癌组织MVD显著高于鼻咽癌无淋巴结转移组,且鼻咽癌MVD与淋巴结转移呈密切(7.68±4.11 V.S3.45±2.21 P0.05)。鼻咽癌瘤周MVD显著高于瘤内(10.07±5.38 V.S 3.22±3.12 P0.05)。CD34表达水平在鼻咽癌不同年龄、性别、T分期之间的差异均无统计学意义,而与临床分期具有统计学意义。 5.鼻咽癌组织中LVD和MVD的计数关系密切,呈一致性趋势。结论微淋巴管及新生血管主要存在鼻咽癌瘤周,瘤内脉管较少;鼻咽癌瘤周LVD及MVD显著高于肿瘤内及癌旁正常组织,且与淋巴结转移显著相关,提示鼻咽癌淋巴管及血管形成与肿瘤进展相关。
[Abstract]:Objective D2 - 40 is a highly specific marker of lymphatic endothelial cells , which can be used to identify lymphatic vessels in normal and tumor tissues , while CD34 is the main specific marker of angiogenesis . The expression of VEGF - C , CD34 , VEGF - C , and VEGFR - 3 proteins in nasopharyngeal carcinoma tissues is detected by immunohistochemistry . The relationship between lymphatic vessel density and microvessel density is analyzed , and the relationship between them and lymph node metastasis of nasopharyngeal carcinoma are analyzed .

Methods From June 2004 to September 2006 , 61 cases of nasopharyngeal carcinoma biopsy specimens ( paraffin embedded ) were selected from the Affiliated Hospital of Guilin Medical College from June 2004 to September 2006 .

Results 1 . The LVD of nasopharyngeal carcinoma was significantly higher than that in non - lymph node metastasis group ( 11.01 卤 2.99 V . S 8.83 卤 1 . 78 P0.05 ) . LVD was significantly higher in NPC than in tumor ( 10.34 卤 2.98 V . S 6.25 卤 2.32 P0.05 ) . LVD counts were not significant in NPC with different ages , sex , T stage ( T _ ( 1 - 2 ) V . S T _ ( 3 - 4 )) and clinical stage .

2 . The positive expression rate of VEGF - C in nasopharyngeal carcinoma was 68.85 % . There was a significant difference between the expression of VEGF - C and the degree of expression of VEGF - C . There was a close relationship between the two groups ( 10.45 卤 4.99 V.S 7.01 卤 2.99 P0.05 ) . The expression of VEGF - C was statistically significant in clinical stage ( I - II V . S III - IV ) , and VEGF - C expression was not statistically significant at different age , sex and T stage of NPC .

3 . The positive rate of VEGFR - 3 and the positive rate of VEGFR - 3 in NPC with lymph node metastasis were statistically significant ( 11.69 卤 4.58 V.S 6.68 卤 2.53 P0.05 ) . The expression of VEGFR - 3 was statistically significant ( 3 / 15 vs . S 35 / 46 P 0.05 ) in different clinical stages ( I - II V . S III - IV ) .

4 . The MVD was significantly higher in NPC tissues and normal nasopharyngeal tissues , and MVD in NPC was significantly higher than that in NPC without lymph node metastasis . MVD was closely related to lymph node metastasis ( 7.68 卤 4.11 V.S 3.45 卤 2.21 P0.05 ) . MVD in NPC was significantly higher than that in the tumor ( 10.07 卤 5.38 V.S 3.22 卤 3.12 P0.05 ) . There was no significant difference between the expression level of CD34 and the age , sex and T stage of NPC .

5 . The counts of LVD and MVD in NPC tissues were closely related and showed a consistent trend .

Conclusion The lymphatic vessels and angiogenesis in nasopharyngeal carcinoma were significantly higher than those in the tumor and adjacent to the adjacent tissues and were significantly correlated with lymph node metastasis , suggesting that the lymphatic vessels and angiogenesis in NPC were correlated with the tumor progression .

【学位授予单位】：桂林医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R739.63

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