摘要
目的探讨肺腺癌中血管内皮生长因子D（VEGF—D）表达水平对病灶^18F-脱氧葡萄糖（FDG）摄取程度的影响，以及评价VEGF—D可否作为预测肺腺癌淋巴结转移的指标之一。方法使用抗VEGF—D抗体对49例肺腺癌病理石蜡包埋切片行免疫组织化学染色。所有患者常规行PET检查，感兴趣区的定量分析采用标准摄取值（SUV）。使用独立样本t检验，χ^2检验及F检验行统计学分析，使用Kaplan·Meier方法计算无瘤生存曲线（log rank分析）。结果（1）在所有病例中及在非细支气管肺泡癌（BAC）病例中，VEGF-D阴性组的FDG摄取程度明显高于阳性组（所有病例SUV分别为4．84±2．14和2．35±1．45，t=4．853，非BAC病例SUV分别为5．26±1．86和2．94±1．40，t=4．266，P均〈0．001）。（2）在所有患者及在非BAC病例中，VEGF—D阳性组中发生淋巴结转移（均为0例χ^2=18．988和15．000，P均〈0．001）及复发（均为5例,χ^2=16．432和12．255，P〈0．001和=0．001）的病例数均明显低于VEGF—D阴性组（所有患者和非BAC患者转移及复发例数均为9例和均为13例）。VEGF—D阳性组中，低度恶性的病例（2组分别为23和12例）均多于高度恶性的病例（均为8例,χ^2=10．018和6．223，P值分别为0．002，0．013）。（3）VEGF—D阳性的患者其无瘤生存率明显高于阴性者[83．33％（25／30）与23．53％（4／17），χ^2=14．05，P〈0．001]。结论高FDG摄取的肺腺癌患者VFGF—D呈明显低表达，且VEGF—D可能作为肺腺癌患者淋巴结转移、组织学分型及复发的预测指标。
Objective Lymph node status is very important for treatment decision of lung adenoeareinoma, ^18F-fluorodeoxyglucose （FDG） uptake is proved to be an independent predictor for lymph node metastasis. The aim of this study was to investigate the impact of vascular endothelial growth factor-D （ VEGF- D） expression on ^18F-FDG uptake and lymph node metastasis in lung adenocareinoma. Methods Fortynine patients with lung adenocarcinoma were enrolled. All had FDG PET scan before surgery and bad immunohistochemical staining with anti-human VEGF-D antibody after surgery. All had clinical follow-up to eighty-nine months after their primary definitive treatment. The independent t-test, χ^2-test and Fisher＇s exact test were used for statistical analysis. Disease-free survival probabilities were calculated with the Kaplan- Meier life table method. Results （ 1 ） Standardized uptake value （ SUV ） was higher in the patients with negative VEGF-D expression than that in those with VEGF-D positive expression （4.84 ± 2.14 vs 2.35 ±1.45, t = 4. 835, P 〈 0. 001 ）. In the subgroup of patients with non-bronchioalveolar carcinoma （BAC） , SUV was also higher in the patients with negative VEGF-D expression than that in those with VEGF-D positive expression （5.26± 1.86 vs 2.94 ± 1.40, t = 4. 266, P 〈 0. 001 ）. （2） Lymph node metastasis and local recurrence were more common in the patients with negative VEGF-D expression （9 lymph node metastasis and 13 local recurrence） than those in patients with VEGF-D positive expression （0 lymph node metastasis and 5 local recurrence, χ^2 = 18. 988,16. 432,both P 〈 0. 001 ）. In the subgroup of patients with non- BAC the results was similar （χ^2 = 15. 000, 12. 255, P 〈 0. 001 or P = 0. 001 ）. The numbers of patients with high grade malignancy were more in VEGF-D negative group than those in VEGF-D positive group （ 13 vs 8, χ^2 = 10.018, P = 0. 002）. （3） Patients with positive VEGF-D expression showed a higher diseasefree survival probability [83.33 % （25/30） vs 23.53 % （4/17）,χ^2 = 14.05, P 〈0. 001 ]. Conclusions It is suggested that lung adenocarcinoma with higher FDG uptake may indicate lower VEGF-D expression. For the patients with lung adenocarcinoma VEGF-D expression may be helpful to evaluate lymph nocle metas-tasis, histological subtypes and recurrence.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2009年第5期297-299,共3页
Chinese Journal of Nuclear Medicine
