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[目的]探讨肿瘤相关巨噬细胞(TAM)表达的血管内皮生长因子C(VEGF-C)在人乳腺癌淋巴管新生及转移中的作用。[方法]采用免疫组织化学双重染色法检测75例乳腺癌组织TAM计数、TAM中VEGF-C表达率,以及癌内、癌周和正常乳腺组织中D2-40阳性微淋巴管密度(LMVD)和淋巴管内皮细胞增殖(LECP),并计数癌细胞淋巴管侵入(LVI),分析它们之间的相关性。[结果]在乳腺癌TAM中VEGF-C呈强阳性表达,且主要分布于癌周。TAM计数为(133.96±46.96)/(×200,0.74mm2)。VEGF-C在TAM中的阳性表达率为26.56%±13.93%。癌周LMVD和LECP分别为12.99±7.97、6.24%±4.00%,显著高于癌内及正常乳腺组织(P<0.05)。癌周LMVD与TAM计数、VEGF-C阳性表达率呈正相关(r=0.528,P=0.001;r=0.874,P<0.001);癌周LECP与TAM计数、VEGF-C阳性表达率呈正相关(r=0.849,P<0.001;r=0.413,P<0.001)。淋巴结转移阳性组LMVD和LECP分别为15.36±8.36和8.98%±2.92%,显著高于阴性组(P<0.05)。LVI阳性组的LMVD和LECP分别为18.12±9.06和11.11%±6.76%,显著高于阴性组(P<0.001)。[结论]TAM在肿瘤微淋巴管新生中起重要角色,可能通过分泌VEGF-C来诱导癌周组织中LECP,从而LMVD增加,最终增加了乳腺癌淋巴转移的可能性。
[Objective] To investigate the role of vascular endothelial growth factor C (VEGF-C) expressed by tumor-associated macrophages (TAM) in lymphangiogenesis and metastasis of human breast cancer. [Method] Immunohistochemical double staining was used to detect the TAM count, the expression of VEGF-C in 75 cases of TAM and the positive rate of D2-40 positive lymphatic vessel (LMVD) in carcinoma, pericancerous and normal breast tissues Lymph tube endothelial cell proliferation (LECP), and count of lymphatic invasion (LVI) of cancer cells, analyze the correlation between them. [Results] The expression of VEGF-C in breast cancer TAM was strongly positive, and mainly distributed in the cancer week. TAM counts were (133.96 ± 46.96) / (× 200, 0.74mm2). The positive expression rate of VEGF-C in TAM was 26.56% ± 13.93%. The weekly LMVD and LECP were 12.99 ± 7.97,6.24% ± 4.00%, which were significantly higher than those in the cancerous and normal breast tissues (P <0.05). The expression of LVD in cancer group was positively correlated with TAM count and VEGF-C positive rate (r = 0.528, P = 0.001; r = 0.874, P <0.001) = 0.849, P <0.001; r = 0.413, P <0.001). The positive rates of LMVD and LECP in lymph node metastasis group were 15.36 ± 8.36 and 8.98% ± 2.92%, respectively, which were significantly higher than those in negative group (P <0.05). The LMVD and LECP in LVI positive group were 18.12 ± 9.06 and 11.11% ± 6.76%, respectively, which were significantly higher than those in negative group (P <0.001). [Conclusion] TAM plays an important role in the neoplasm of lymphatic neoplasms. It may induce the LECP in the pericarcinoma tissues through the secretion of VEGF-C, thus increasing the LMVD and finally increasing the possibility of lymphatic metastasis in breast cancer.