VEGF與VEGFR-2在軟組織肉瘤中的表達(dá)及其臨床意義
發(fā)布時(shí)間：2018-12-14 17:07
【摘要】：目的:通過(guò)免疫組織化學(xué)方法檢測(cè)VEGF、VEGFR-2及MVD在軟組織肉瘤組織中表達(dá)情況,分析他們表達(dá)的相關(guān)性。以了解VEGF及VEGFR-2的表達(dá)是否與臨床預(yù)后生存時(shí)間有關(guān)。方法:回顧性分析自2005年至2015年間在河北醫(yī)科大學(xué)第四醫(yī)院接受手術(shù)治療的軟組織肉瘤患者共94例,通過(guò)免疫組織化學(xué)方法分析了軟組織肉瘤石蠟包塊中VEGF、VEGFR-2及CD34的蛋白表達(dá),并將染色結(jié)果分類(lèi),微血管計(jì)數(shù)(MVD)通過(guò)CD34在內(nèi)皮細(xì)胞的表達(dá)來(lái)進(jìn)行計(jì)數(shù),統(tǒng)計(jì)分析VEGF、VEGFR-2的在軟組織肉瘤中的表達(dá)與其預(yù)后的關(guān)系。結(jié)果:1試驗(yàn)對(duì)象94例,其中女性51例,男性43例,平均年齡為50歲(范圍為10-83歲)。94例軟組織肉瘤包括纖維肉瘤(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)。腫瘤起源分布如下:42.6%的軀干,四肢31.9%,9.6%的頭部和頸部,4.3%后腹腔內(nèi)器官和11.7%腹膜后組織。組織病理學(xué)分類(lèi)(P0.001),腫瘤分級(jí)(P=0.005),TNM分期(P=0.004),腫瘤的部位深淺(P=0.012)和是否有遠(yuǎn)處轉(zhuǎn)移(P=0.005)都與總生存期相關(guān)。2 VEGF、VEGFR-2、MVD表達(dá)水平與性別,腫瘤位置,組織病理學(xué)分類(lèi),腫瘤大小,腫瘤深度及是否轉(zhuǎn)移差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。VEGF高表達(dá)與患者年齡(P=0.008),腫瘤分級(jí)(P0.001)和TNM分期(P=0.003)相關(guān)。VEGFR-2高表達(dá)與腫瘤分級(jí)(P0.001)和TNM分期(P=0.010)相關(guān)。MVD高表達(dá)與惡性腫瘤分級(jí)相關(guān)(P=0.004)。3 VEGF表達(dá)與VEGFR-2表達(dá)呈正相關(guān),其相關(guān)性系數(shù)為R=0.652,有統(tǒng)計(jì)學(xué)意義(P0.001)。VEGFR-2高表達(dá)組的平均MVD顯著大于VEGFR-2低表達(dá)組的平均MVD(63:41,P=0.007),而高和低VEGF表達(dá)組之間的平均MVD差異無(wú)統(tǒng)計(jì)學(xué)意義(53:49,P=0.572)。4通過(guò)Kaplan-Meier法顯示:VEGF和VEGFR-2在STS組織中的表達(dá)與患者總生存時(shí)間顯著相關(guān)(P=0.003,P=0.002)。用Cox比例風(fēng)險(xiǎn)模型對(duì)組織學(xué)亞型、是否發(fā)生轉(zhuǎn)移、腫瘤的深度、腫瘤的分級(jí)、TNM分期、VEGF表達(dá)和VEGFR-2表達(dá)進(jìn)行多變量回歸分析。結(jié)果顯示:VEGF表達(dá)(P=0.018)與STS預(yù)后顯著相關(guān),并且是OS的獨(dú)立的危險(xiǎn)因素。5 VEGFR-2表達(dá)不同與患者的預(yù)后有顯著差異,并且隨著組織中表達(dá)水平的增高,患者生存時(shí)間縮短,有統(tǒng)計(jì)學(xué)意義(P=0.003)。VEGF高表達(dá)的患者預(yù)后生存期顯著低于低表達(dá)的患者(P=0.002)。而MVD的表達(dá)高低與患者的預(yù)后生存期無(wú)統(tǒng)計(jì)學(xué)意義(P=0.375)。結(jié)論:1 VEGF表達(dá)與STS預(yù)后顯著相關(guān),并且是OS的顯著的獨(dú)立危險(xiǎn)因素。2 VEGF與VEGFR-2在軟組織肉瘤中的表達(dá)呈正相關(guān)。3 VEGFR-2高表達(dá)組的平均MVD顯著大于VEGFR-2低表達(dá)組的平均MVD,而高和低VEGF蛋白表達(dá)組之間的平均MVD無(wú)明顯差異,提示VEGF可能通過(guò)VEGFR-2傳導(dǎo)信號(hào)發(fā)揮內(nèi)皮細(xì)胞增殖和微血管形成的作用。4 VEGF、VEGFR-2、MVD表達(dá)水平與性別、腫瘤位置、組織病理學(xué)分類(lèi)、腫瘤大小、腫瘤深度或是否轉(zhuǎn)移無(wú)統(tǒng)計(jì)學(xué)意義。VEGF的高表達(dá)與患者年齡、腫瘤分級(jí)和TNM分期相關(guān)。VEGFR-2高表達(dá)與腫瘤分級(jí)和TNM分期相關(guān)。MVD的高表達(dá)只與惡性腫瘤分級(jí)相關(guān)。5軟組織肉瘤患者生存時(shí)間隨著VEGF與VEGFR-2的表達(dá)的不同而呈現(xiàn)明顯的差異,且VEGF與VEGFR-2的表達(dá)變高,則患者生存期變短。
[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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R738.6
本文編號(hào)：2378990
[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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R738.6
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 Yuan Chang;Wei Niu;Pei-long lian;xian-qiang Wang;Zhi-xin Meng;Yi liu;Rui Zhao;;Endocan-expressing microvessel density as a prognostic factor for survival in human gastric cancer[J];World Journal of Gastroenterology;2016年23期
，本文編號(hào)：2378990
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