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目的:探讨趋化因子受体4(CXCR4)、端粒酶逆转录酶(hTERT)在胶质瘤中的表达与肿瘤微血管密度(MVD)及预后的关系。方法:应用免疫组织化学技术检测156例胶质瘤中CXCR4及hTERT的表达,以血管内皮生长因子(VEGF)标记检测微血管密度,分析CXCR4、hTERT表达及MVD与生存时间的关系。结果:①CXCR4、hTERT总阳性率分别为53.8%(84/156)、50.6%(79/156);Ⅱ、Ⅲ、Ⅳ级胶质瘤中CXCR4的阳性率分别为30.8%(16/52)、56.5%(39/69)、82.9%(29/35),hTERT的阳性率分别为26.9%(14/52)、53.6%(37/69)、80.0%(28/35),CXCR4和hTERT在不同级别胶质瘤中的表达差异有统计学意义(P<0.01);②156例胶质瘤中MVD均值为44.17±13.43,Ⅱ、Ⅲ、Ⅳ级MVD均值分别为29.85±4.34、50.12±17.80、52.53±18.16(P<0.01);③Ⅱ、Ⅲ、Ⅳ级胶质瘤患者术后中位生存时间分别为30.2、11.7、9.8个月;CXCR4、hTERT阳性表达组中MVD≥44.17的病例术后中位生存时间明显短于阴性表达组及MVD<44.17的病例(P<0.01)。结论:CXCR4、hTERT的高表达可促进胶质瘤血管生成和侵袭性生长,三者联合检测有助于预后评估。
Objective: To investigate the relationship between the expression of chemokine receptor 4 (CXCR4) and telomerase reverse transcriptase (hTERT) in glioma and its relationship with tumor microvessel density (MVD) and prognosis. Methods: The expression of CXCR4 and hTERT in 156 cases of gliomas was detected by immunohistochemistry. The density of microvessels was detected by vascular endothelial growth factor (VEGF) markers. The expression of CXCR4, hTERT and the relationship between MVD and survival time were analyzed. Results: ① The positive rates of CXCR4 and hTERT were 53.8% (84/156) and 50.6% (79/156) respectively. The positive rates of CXCR4 in grade Ⅱ, Ⅲ and Ⅳ gliomas were 30.8% (16/52) The positive rate of hTERT in 26.5% (14/52), 53.6% (37/69) and 80.0% (28/35) cases were 56.5% (39/69) and 82.9% (29/35) (P <0.01). ② The mean MVD in 156 gliomas was 44.17 ± 13.43, the mean MVD in grades Ⅱ, Ⅲ and Ⅳ were 29.85 ± 4.34 and 50.12 ± 17.80, respectively, and the difference was statistically significant 52.53 ± 18.16 (P <0.01) .③The median postoperative survival time was 30.2, 11.7 and 9.8 months in patients with gradeⅡ, Ⅲ and Ⅳ gliomas respectively. Among the patients with positive expression of CXCR4 and hTERT, MVD≥44.17 The survival time was significantly shorter than that in the negative expression group and MVD <44.17 (P <0.01). Conclusion: The high expression of CXCR4 and hTERT can promote the angiogenesis and invasive growth of gliomas, and the combined detection of them can contribute to the prognosis evaluation.