【摘要】：目的：通過研究D2-40在腎透明細(xì)胞癌中的表達(dá)來探討淋巴管新生與腎透明細(xì)胞癌患者預(yù)后的關(guān)系。 方法：研究對象是在石河子大學(xué)第一附屬醫(yī)院泌尿外科收集的從2005年1月至2012年10月被診斷為腎透明細(xì)胞癌的60位患者。從我院病統(tǒng)科調(diào)閱入選患者的病歷資料，對研究對象的臨床資料進(jìn)行歸納總結(jié)，包括性別、年齡、淋巴結(jié)是否清掃、淋巴結(jié)轉(zhuǎn)移、遠(yuǎn)處轉(zhuǎn)移、腫瘤T分期及Fuhrman細(xì)胞核分級。在我院病理科調(diào)閱60名患者的HE切片，挑選同時具有癌組織和正常組織的石蠟塊。通過免疫組織化學(xué)染色的方法利用D2-40在淋巴管內(nèi)皮細(xì)胞中的表達(dá)來標(biāo)記60例腎透明細(xì)胞癌患者標(biāo)本中的淋巴管。利用光學(xué)顯微鏡來測定癌周淋巴管密度（peritumoral lymphatic vessels density，PLVD）以及觀察癌內(nèi)淋巴管（intratumoral lymphatic vessels，ILV）是否出現(xiàn)，從而評價PLVD及ILV與臨床病理因素的相關(guān)性，及其與患者預(yù)后的關(guān)系。利用SPSS17.0版軟件進(jìn)行數(shù)據(jù)統(tǒng)計學(xué)分析。 結(jié)果：所有研究對象的平均PLVD為16.89，將研究對象分為PLVD≥16.89和PLVD＜16.89兩組，將PLVD與臨床病理因素進(jìn)行相關(guān)性分析。結(jié)果表明PLVD與遠(yuǎn)處轉(zhuǎn)移（P=0.073）、淋巴結(jié)轉(zhuǎn)移（P=0.758）、Fuhrman細(xì)胞核分級（P=0.866）和腫瘤T分期（P=0.653）無相關(guān)性，結(jié)果無統(tǒng)計學(xué)意義。ILV的出現(xiàn)與遠(yuǎn)處轉(zhuǎn)移（P=0.001）、淋巴結(jié)轉(zhuǎn)移（P=0.017）及Fuhrman細(xì)胞核分級（P=0.002）有相關(guān)性，與腫瘤T分期（P=0.570）無相關(guān)性。生存分析顯示PLVD≥16.89組總體生存率是34.9%，中位生成時間是52±9個月，PLVD＜16.89組總體生存率是42.30%，中位生成時間是71±20個月，相比較兩組的生存率無統(tǒng)計學(xué)意義（P=0.223）；ILV陽性組的總體生存率是17.50%，中位生成時間是26±3個月，ILV陰性組的總體生存率是46.00%，中位生成時間是71個月，相比較結(jié)果有統(tǒng)計學(xué)意義（P=0.000）。多因素Cox回歸分析表明腫瘤T分期和ILVs是腎透明細(xì)胞癌患者的獨立預(yù)后因素，P值分別是0.006和0.001。 結(jié)論：D2-40在淋巴管高表達(dá)，，對于血管則不表達(dá)，能清晰的區(qū)分淋巴管和血管。癌周淋巴管新生對患者的預(yù)后可能無影響；癌內(nèi)淋巴管新生對患者的預(yù)后可能有不良影響。多因素分析表明在不考慮淋巴結(jié)轉(zhuǎn)移的情況下，腫瘤T分期及ILVs是腎透明細(xì)胞癌患者的獨立預(yù)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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