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目的:探讨血管内皮生长因子C(VEGF-C)的表达对胃食管交界癌淋巴管生成及患者预后的影响。方法:免疫组化法检测128例行根治术的胃食管交界癌组织中VEGF-C的表达,采用LeicaIM50系统采集图像,Image-pro○RPlus6.0软件计算平均光密度值(MOD);D2-40标记淋巴管并计算淋巴管密度(LVD)。结果:VEFG-C高、低表达组(MOD>0.18,≤0.18)的LVD值分别为16.90±5.96和13.60±5.58条,P=0.002,送检阳性淋巴结数分别为2.90±2.44和2.00±2.36枚,P=0.025;LVD高、低水平组(LVD>13条,≤13条)的阳性淋巴结送检数分别为3.00±2.34和1.90±2.43枚,P=0.010。单因素生存分析显示,高VEGF-C表达组及高LVD组的患者无瘤生存情况明显差于相应的低表达/水平组。多因素分析提示,VEGF-C高表达为独立于其他临床因素(TNM分期、有否化疗、手术切缘范围)的预后不良影响因素。结论:胃食管交界癌VEGF-C高表达与LVD正相关,是独立的预后不良影响因素。
Objective: To investigate the effect of vascular endothelial growth factor C (VEGF-C) expression on lymphangiogenesis and prognosis of gastroesophageal junctional carcinomas. Methods: The expression of VEGF-C in 128 cases of radical surgery of the gastroesophageal junction carcinoma was detected by immunohistochemistry. The images were collected by LeicaIM50 system and the average optical density (MOD) was calculated by Image-pro ○ RPlus 6.0 software. The expression of D2- 40 labeled lymphatic vessels and calculated lymphatic vessel density (LVD). Results: The LVD of VEFG-C high and low expression group (MOD> 0.18, ≤0.18) were 16.90 ± 5.96 and 13.60 ± 5.58, respectively, P = 0.002. The number of positive lymph nodes examined were 2.90 ± 2.44 and 2.00 ± 2.36 (P = 0.025). The number of positive lymph nodes in high and low LVD group (LVD> 13, ≤13) were 3.00 ± 2.34 and 1.90 ± 2.43, respectively, P = 0.010. Univariate survival analysis showed that the tumor-free survival of patients with high VEGF-C expression and high LVD group was significantly lower than that of the corresponding low expression / level group. Multivariate analysis suggested that VEGF-C overexpression was an adverse prognostic factor independently of other clinical factors (TNM stage, chemotherapy, surgical margin). Conclusion: The high expression of VEGF-C in gastroesophageal junction cancer is positively correlated with LVD, which is an independent prognostic factor.