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目的:探讨激酶型纤溶酶原激活物(urokinase-type plasminogen activator,uPA)和血管内皮生长因子(vascular endothelial growth factor,VEGF)及微血管密度(microvascular density,MVD)在卵巢恶性生殖细胞肿瘤(malignant ovarian germ cell tumor,MOGCT)侵袭转移中的作用及其预后价值。方法:应用免疫组织化学方法检测43例MOGCT及10例正常卵巢组织中uPA和VEGF蛋白的表达情况,同时标记CD34肿瘤新生血管,计算MVD。结果:uPA和VEGF的阳性表达率及MVD值在MOGCT患者不同年龄、不同病理类型、不同腹腔积液程度、有无网膜转移、有无肝转移上差异无统计学意义(P>0.05);uPA和VEGF的阳性表达率、表达强度及MVD值在不同FIGO分期、有无淋巴结转移上差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线显示uPA蛋白阳性表达者的生存期较阴性表达者明显缩短,uPA与MOGCT的总生存期有关(P<0.05);Cox比例风险模型分析提示,uPA蛋白表达越强、MVD值越高患者预后越差,二者可影响患者的生存期。结论:uPA,VEGF的表达及MVD值与MOGCT的侵袭转移密切相关;uPA和MVD可作为判断MOGCT的预后指标。
Objective: To investigate the expression of urokinase-type plasminogen activator (uPA) and vascular endothelial growth factor (VEGF) and microvascular density (MVD) in malignant ovarian germ cell tumors ovarian germ cell tumor (MOGCT) in invasion and metastasis and its prognostic value. Methods: The expressions of uPA and VEGF in 43 cases of MOGCT and 10 cases of normal ovarian tissue were detected by immunohistochemistry. Meanwhile, the neovascularization of CD34 tumor was marked and the MVD was calculated. Results: The positive expression rates of MVD and MVD in patients with MOGCT at different ages, different pathological types, different degrees of ascites, with or without omentum metastasis, with or without liver metastasis showed no significant difference (P> 0.05). The positive expression rate of uPA and VEGF, the intensity of expression and the MVD in different FIGO stage and lymph node metastasis were significantly different (P <0.05). Kaplan-Meier survival curves showed that the survival of patients with positive expression of uPA protein was significantly shorter than that of negative expression, uPA was associated with the overall survival of MOGCT (P <0.05); Cox proportional hazards model analysis showed that the higher uPA protein expression, MVD The higher the patient’s prognosis, the worse, both can affect the patient’s survival. Conclusion: The expressions of uPA, VEGF and MVD are closely related to the invasion and metastasis of MOGCT. Both uPA and MVD can be used as prognostic indicators for MOGCT.