摘要
目的探讨血管生成拟态(vasculogenic mimicry,VM)与血管内皮生长因子-C(vascular endothelial growthfactor-C,VEGF-C)在骨肉瘤中的表达及临床意义。方法应用免疫组织化学及CD34和过碘酸-雪夫(periodic acid-shiff,PAS)套染法,检测活检术后切除组织108例骨肉瘤及20例骨软骨瘤中VM、VEGF-C的表达及微血管密度(mi-crovessel density,MVD),统计分析三者之间及其与患者临床病理因素和预后之间的关系。结果 VM、VEGF-C过表达及MVD≥23阳性率在骨肉瘤组织分别为61.11%(66/108)、60.19%(65/108)及59.26%(64/108),在骨软骨瘤组织分别为0%(0/20)、25%(5/20)及20%(4/20),差异有统计学意义(均P<0.05);VM、VEGF-C过表达及MVD两两之间正相关,且均与骨肉瘤病理分级、软组织浸润、远处转移、Enneking分期及患者术后生存期有关(均P<0.01);及COX多因素分析提示远处转移、病理分级、Enneking分期、VM和VEGF-C表达水平及MVD是影响骨肉瘤患者预后的独立危险因素(均P<0.05)。结论 VM可能是判断骨肉瘤预后的新指标,联合检测VM、VEGF-C和MVD对骨肉瘤的进展、预后判断有重要意义。
Objective To investigate the clinical significance of vasculogenic mimicry（VM） and the expression of vascular endothelial growth factor-C（VEGF-C） in osteosarcoma. Methods The VM,the expression level of VEGF-C and the microves- sel density（MVD） were determined in a total of 108 osteosarcoma specimens by immunohistochemistry or dual staining for CD34 and periodic acid-schiff（PAS）. Twenty osteochondroma specimens served as control. The association of VM/VEGF-C/ MVD with the clinicopathological characteristics and prognosis of osteosarcoma patients was statistically analyzed as well as the relationship among VM,VEGF-C ang MVD in osteosarcoma. Results The positive rate of VM,over-expression of VEGF-C and MVD≥23 in osteosarcomas was 61.11% （66/108）, 60.19 % （65/108） and 59.26 % （64/108）, respectively, significantly higher than that in osteochondromas with the value being 0 % （0/20）, 25 % （5/20） and 20 %（4/20）, respectively（P〈0.05 for all）. The VM, MVD and over-expression of VEGF-C were significantly associated with parenchyma infiltration,distant metastasis, patho- logical grade, Enneking stage and postoperative survival time（P〈0.05 for all）. A positive relation was found among the VM, the expression of VEGF-C and MVD（P〈0.05 for all）. Cox multifactor regression analysis indicated that the parenchyma infil tration,distant metastasis,pathology grade, Enneking stage, VM, MVD and expression of VEGF-C were independent risk fac- tors of osteosareoma（P〈0.05 for all）. Conclusion The VM may become a novel marker for predicting the prognosis of osteo- sarcoma. Combined detection for VM,VEGF-C and MVD carries important clinical significance in the prediction of development and prognosis of osteosarcoma;
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2013年第2期130-136,共7页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
基金
国家自然科学基金资助项目(No.81171465)
关键词
骨肉瘤
血管生成拟态
血管内皮生长因子-C
微血管密度
预后
osteosarcoma
vasculogenic mimicry
vascular endothelial growth factor-C
microvessel density
prognosis
