论文部分内容阅读
目的:通过观察胸腺上皮源性肿瘤微血管生成与部分临床病理参数的关系和对患者生存期的影响,探讨微血管密度(microvessel density,MVD)作为评估患者预后指标的临床意义。方法:用免疫组织化学Envision法检测单克隆抗体CD34在66例胸腺上皮源性肿瘤手术切除标本中的表达,对其中62例患者随访16～178个月并进行生存分析。结果:MVD在不同性别和年龄组中的差别均无显著性差异(P>0.05),肿瘤体积增大(≥11.0 cm)时MVD有增高趋势,但与对照组(<11.0 cm)比较差别无统计学意义(P>0.05)。MVD在各组织学类型之间存在显著性差异(P<0.05),各Masaoka临床分期之间的差异也有统计学意义(P<0.01)。患者是否合并重症肌无力不影响MVD值(P>0.05)。Kaplan-Meier生存曲线显示不同组织学类型之间生存率存在显著性差异(P<0.01),Masaoka临床各分期之间生存率也存在显著性差异(P<0.01),高MVD值组(≥37.0)5年和10年生存率显著低于低MVD值组(<37.0),差别有统计学意义(P<0.05)。结论:促微血管生成可能是胸腺上皮源性肿瘤侵袭生长和临床演进的重要事件,MVD可以作为判断胸腺上皮源性肿瘤患者预后的有价值指标,将MVD、WHO组织学分型、Masaoka临床分期结合起来更有利于评估患者的预后。
OBJECTIVE: To evaluate the clinical significance of microvessel density (MVD) as a prognostic indicator in patients with thymus-derived epithelial tumor by observing the relationship between microangiogenesis and some clinical and pathological parameters and its impact on the survival of patients. Methods: Immunohistochemical Envision method was used to detect the expression of monoclonal antibody CD34 in 66 cases of thymic epithelial tumor resected. Sixty-two of them were followed up for 16-178 months and their survival was analyzed. Results: There was no significant difference in MVD between different sexes and age groups (P> 0.05). MVD increased when the tumor volume increased (> 11.0 cm), but there was no difference between MVD and control group (<11.0 cm) Statistical significance (P> 0.05). There was significant difference between MVD in histological types (P <0.05). There was also significant difference in each Masaoka clinical stage (P <0.01). Whether patients with myasthenia gravis did not affect MVD (P> 0.05). Kaplan-Meier survival curves showed significant differences in survival rates between different histological types (P <0.01), and significant differences in survival rates between Masaoka clinical stages (P <0.01) and in high MVD groups (≥37.0 ) 5-year and 10-year survival rates were significantly lower than the low MVD group (<37.0), the difference was statistically significant (P <0.05). Conclusions: Angiogenesis may be an important event in the invasive growth and clinical evolution of thymus-derived tumors. MVD can be used as a valuable indicator to evaluate the prognosis of patients with thymus-derived epithelial tumor. MVD, WHO histological classification, and clinical staging of Masaoka More conducive to assess the patient’s prognosis.