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目的 探讨血管内皮细胞生长因子(vascularendothelial growth factor,VEGF)在原发性肝癌中的表达及其与预后的关系。方法 应用组织微阵列新技术(tissuemicroarray)和免疫组织化学染色方法回顾性研究165例行手术切除并经病理学证实的肝细胞肝癌标本中VEGF的表达情况,Log-rank法比较不同VEGF表达组间生存率和无瘤生存率的差别,COX回归模型进行单因素、多因素分析比较各有关因素对生存率的影响。结果VEGF表达主要见于肿瘤胞浆内,肿瘤VEGF表达与肝癌病人总生存和无瘤生存显著相关,VEGF表达强阳性患者的l、3、5年总生存率和无瘤生存率分别为51.69%、30.71%、11.08%和76.92%、38.46%、14.96%,P值分别为0.0000和0.0056。COX回归模型单因素分析肿瘤大小、数目、分化程度、癌栓和VEGF表达是影响肝癌病人生存的相关因素,仅肿瘤大小、VEGF表达与无瘤生存相关;多因素分析则发现肿瘤分化程度和VEGF表达是肝癌患者生存的影响因素,仅VEGF表达与无瘤生存相关。结论 组织微阵列技术为一种高效、快速的分子生物学研究方法。VEGF表达与肝癌复发及预后密切相关,可作为肝癌病人的独立的预后指标。
Objective To investigate the expression of vascular endothelial growth factor (VEGF) in primary liver cancer and its relationship with prognosis. Methods Tissue microarray and immunohistochemical staining methods were used to retrospectively study the expression of VEGF in 165 cases of hepatocellular carcinoma specimens that were surgically removed and confirmed by pathology. Log-rank method was used to compare different VEGF expression groups. The difference between survival rate and disease-free survival rate, COX regression model for single factor, multi-factor analysis to compare the impact of various factors on the survival rate. Results The expression of VEGF was mainly found in the cytoplasm of tumors. The expression of tumor VEGF was significantly associated with overall survival and disease-free survival of patients with hepatocellular carcinoma. The 1-, 3-, 5-year overall survival and disease-free survival rates of patients with strong positive VEGF expression were 51.69%. 30.71%, 11.08% and 76.92%, 38.46%, 14.96%, P values were 0.0000 and 0.0056, respectively. The single factor analysis of COX regression model of tumor size, number, differentiation, tumor thrombus and VEGF expression were related factors affecting the survival of liver cancer patients. Only tumor size, VEGF expression and disease-free survival were related; multivariate analysis found that tumor differentiation and VEGF Expression is an influential factor for the survival of patients with liver cancer, and only VEGF expression is associated with disease-free survival. Conclusion Tissue microarray technology is an efficient and rapid molecular biology research method. The expression of VEGF is closely related to the recurrence and prognosis of HCC. It can be used as an independent prognostic indicator for HCC patients.