VEGF与VEGFR-2在软组织肉瘤中的表达及其临床意义

发布时间：2018-12-14 17:07

【摘要】：目的:通过免疫组织化学方法检测VEGF、VEGFR-2及MVD在软组织肉瘤组织中表达情况,分析他们表达的相关性。以了解VEGF及VEGFR-2的表达是否与临床预后生存时间有关。方法:回顾性分析自2005年至2015年间在河北医科大学第四医院接受手术治疗的软组织肉瘤患者共94例,通过免疫组织化学方法分析了软组织肉瘤石蜡包块中VEGF、VEGFR-2及CD34的蛋白表达,并将染色结果分类,微血管计数(MVD)通过CD34在内皮细胞的表达来进行计数,统计分析VEGF、VEGFR-2的在软组织肉瘤中的表达与其预后的关系。结果:1试验对象94例,其中女性51例,男性43例,平均年龄为50岁(范围为10-83岁)。94例软组织肉瘤包括纤维肉瘤(n=49),滑膜肉瘤(n=21),脂肪肉瘤(n=18)和未分化多形性肉瘤(n=6)。肿瘤起源分布如下:42.6%的躯干,四肢31.9%,9.6%的头部和颈部,4.3%后腹腔内器官和11.7%腹膜后组织。组织病理学分类(P0.001),肿瘤分级(P=0.005),TNM分期(P=0.004),肿瘤的部位深浅(P=0.012)和是否有远处转移(P=0.005)都与总生存期相关。2 VEGF、VEGFR-2、MVD表达水平与性别,肿瘤位置,组织病理学分类,肿瘤大小,肿瘤深度及是否转移差异无统计学意义(P0.05)。VEGF高表达与患者年龄(P=0.008),肿瘤分级(P0.001)和TNM分期(P=0.003)相关。VEGFR-2高表达与肿瘤分级(P0.001)和TNM分期(P=0.010)相关。MVD高表达与恶性肿瘤分级相关(P=0.004)。3 VEGF表达与VEGFR-2表达呈正相关,其相关性系数为R=0.652,有统计学意义(P0.001)。VEGFR-2高表达组的平均MVD显着大于VEGFR-2低表达组的平均MVD(63:41,P=0.007),而高和低VEGF表达组之间的平均MVD差异无统计学意义(53:49,P=0.572)。4通过Kaplan-Meier法显示:VEGF和VEGFR-2在STS组织中的表达与患者总生存时间显著相关(P=0.003,P=0.002)。用Cox比例风险模型对组织学亚型、是否发生转移、肿瘤的深度、肿瘤的分级、TNM分期、VEGF表达和VEGFR-2表达进行多变量回归分析。结果显示:VEGF表达(P=0.018)与STS预后显著相关,并且是OS的独立的危险因素。5 VEGFR-2表达不同与患者的预后有显著差异,并且随着组织中表达水平的增高,患者生存时间缩短,有统计学意义(P=0.003)。VEGF高表达的患者预后生存期显著低于低表达的患者(P=0.002)。而MVD的表达高低与患者的预后生存期无统计学意义(P=0.375)。结论:1 VEGF表达与STS预后显著相关,并且是OS的显着的独立危险因素。2 VEGF与VEGFR-2在软组织肉瘤中的表达呈正相关。3 VEGFR-2高表达组的平均MVD显着大于VEGFR-2低表达组的平均MVD,而高和低VEGF蛋白表达组之间的平均MVD无明显差异,提示VEGF可能通过VEGFR-2传导信号发挥内皮细胞增殖和微血管形成的作用。4 VEGF、VEGFR-2、MVD表达水平与性别、肿瘤位置、组织病理学分类、肿瘤大小、肿瘤深度或是否转移无统计学意义。VEGF的高表达与患者年龄、肿瘤分级和TNM分期相关。VEGFR-2高表达与肿瘤分级和TNM分期相关。MVD的高表达只与恶性肿瘤分级相关。5软组织肉瘤患者生存时间随着VEGF与VEGFR-2的表达的不同而呈现明显的差异,且VEGF与VEGFR-2的表达变高,则患者生存期变短。
[Abstract]:Objective: To detect the expression of VEGF, VEGFR-2 and MVD in the tissue of soft tissue sarcoma by immunohistochemistry, and to analyze the correlation between the expression of VEGF, VEGFR-2 and MVD. To understand whether the expression of VEGF and VEGFR-2 is related to the time of clinical prognosis. Methods: 94 cases of soft tissue sarcoma treated by surgery from 2005 to 2015 in the fourth hospital of Hebei Medical University were analyzed retrospectively. The expression of VEGF, VEGFR-2 and CD34 in the paraffin block of soft tissue sarcoma was analyzed by immunohistochemical method, and the staining results were classified. Microvessel counts (MVD) were counted by the expression of CD34 in the endothelial cells, and the relationship between the expression of VEGF and VEGFR-2 in the soft tissue sarcoma and its prognosis was analyzed. Results: There were 94 cases of soft tissue sarcoma including fibrosarcoma (n = 49), synovial sarcoma (n = 21), liposarcoma (n = 18) and non-differentiated pleomorphic sarcoma (n = 6). The origin of the tumor is as follows: 42.6% of the trunk, 30.9% of the limbs, 9. 6% of the head and neck, 4. 3% of the intra-abdominal organ and the 11. 7% retroperitoneal tissue. Histopathological classification (P = 0.001), tumor grade (P = 0.05), TNM stage (P = 0. 004), depth of tumor (P = 0.012) and distant metastasis (P = 0. 005) were related to the overall survival time. VEGF, VEGFR-2, MVD expression level and sex, tumor location, tissue pathology classification, tumor size, The tumor depth and the difference of metastasis were not significant (P0.05). The high expression of VEGF was related to the age of the patient (P = 0. 008), the tumor grade (P = 0.001) and TNM stage (P = 0.003). The high expression of VEGFR-2 was related to the classification of tumor (P = 0.001) and TNM stage (P = 0. 010). The expression of VEGF was positively correlated with the expression of VEGFR-2, and its correlation coefficient was R = 0.652, which was of statistical significance (P 0.001). The mean MVD of VEGFR-2 high expression group was higher than that of VEGFR-2 low expression group (63: 41, P = 0.007). The expression of VEGF and VEGFR-2 in STS was significantly correlated with the overall survival time of the patients (P = 0.003, P = 0.002). A Cox proportional risk model was used to analyze the histological subtypes, the occurrence of metastasis, the depth of the tumor, the grade of the tumor, the TNM stage, the expression of VEGF and the expression of VEGFR-2. The results showed that the expression of VEGF (P = 0.018) was significantly related to the prognosis of STS and was an independent risk factor for OS. The prognosis of patients with high VEGF expression was significantly lower than those with low expression (P = 0. 002). The expression of MVD was not related to the survival time of the patients (P = 0.375). Conclusion: The expression of VEGF is significantly related to the prognosis of STS, and is an independent risk factor for OS. VEGF and VEGFR-2 are positively correlated with the expression of VEGFR-2 in soft tissue sarcoma. The mean MVD in the 3 VEGFR-2 high expression group is higher than that of VEGFR-2 low expression group. The expression of VEGF, VEGFR-2, MVD, the level of expression of VEGF, VEGFR-2, MVD and the size of the tumor, The depth of the tumor or the metastasis was not statistically significant. The high expression of VEGF was associated with the patient's age, tumor grade and TNM stage. The high expression of VEGFR-2 was associated with tumor grade and TNM stage. The high expression of MVD was only correlated with the grade of malignant tumor. The survival time of the 5 soft-tissue sarcoma patients showed a significant difference with the expression of VEGF and VEGFR-2, and the expression of VEGF and VEGFR-2 was high, and the survival time of the patients was shortened.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R738.6

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