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目的通过检测类肝素酶-1(HPA)、血管内皮生长因子(VEGF)在良、恶性嗜铬细胞瘤中的表达情况,探讨HPA、VEGF能否成为预测恶性嗜铬细胞瘤的指标,并阐明二者间的关系。方法选取1986年10月～2006年8月住院经手术治疗,且具有完整的临床、病理和随访资料的嗜铬细胞瘤患者存档石蜡标本38例,其中良性嗜铬细胞瘤21例,恶性嗜铬细胞瘤17例。恶性嗜铬细胞瘤组中首次手术确诊为嗜铬细胞瘤后随访28～179个月;良性嗜铬细胞瘤组中首次手术确诊为嗜铬细胞瘤后随访93～264个月。另取20例因良性肾疾患行肾切除时获取的同侧正常肾上腺组织作为对照组。采用免疫组织化学技术,检测良、恶性嗜铬细胞瘤及20例正常肾上腺髓质组织中HPA和VEGF的表达情况。结果HPA在恶性嗜铬细胞瘤中高表达(76.47%),在良性嗜铬细胞瘤中表达较低(28.57%),在正常肾上腺髓质组织中无表达,恶性嗜铬细胞瘤组与良性嗜铬细胞瘤组及恶性嗜铬细胞瘤组与正常肾上腺髓质组织组之间HPA的表达有显著性差异(P<0.05)。VEGF在恶性嗜铬细胞瘤中呈高表达,阳性率为82.40%,在良性嗜铬细胞瘤和正常肾上腺髓质组织中的阳性率分别为23.80%、5.00%,VEGF在恶性嗜铬细胞瘤中的表达与在良性嗜铬细胞瘤和正常肾上腺髓质组织中的表达有显著性差异(P<0.05)。在嗜铬细胞瘤中HPA与VEGF的表达呈正相关。结论HPA和VEGF有望成为预测恶性嗜铬细胞瘤的指标。
Objective To investigate the expression of HPA and VEGF in malignant pheochromocytoma by detecting the expression of heparanase-1 (HPA) and vascular endothelial growth factor (VEGF) Clarify the relationship between the two. Methods 38 cases of pheochromocytoma were admitted to our hospital from October 1986 to August 2006 with complete clinical, pathological and follow-up data. Among them, there were 38 cases of benign pheochromocytoma, 21 cases of malignant chrome 17 cases of cell tumor. The malignant pheochromocytoma group was followed up for 28-179 months after the first operation was diagnosed as pheochromocytoma. The patients with benign pheochromocytoma were followed up for 93-264 months after the first operation was diagnosed as pheochromocytoma. Another 20 cases of nephrectomy due to benign renal disease obtained ipsilateral normal adrenal tissue as a control group. Immunohistochemistry was used to detect the expression of HPA and VEGF in benign and malignant pheochromocytomas and 20 normal adrenal medulla tissues. Results HPA was highly expressed in malignant pheochromocytoma (76.47%), low expression in benign pheochromocytoma (28.57%), non-expressed in normal adrenal medulla tissue. Malignant pheochromocytoma group was associated with benign chromaffin There was a significant difference in the expression of HPA between the cell tumor group, the malignant pheochromocytoma group and the normal adrenal medulla tissue group (P <0.05). VEGF was highly expressed in malignant pheochromocytomas with a positive rate of 82.40%. The positive rates of VEGF in benign pheochromocytoma and normal adrenal medulla were 23.80% and 5.00%, respectively. The positive rates of VEGF in malignant pheochromocytoma There was a significant difference (P <0.05) between the expression in benign pheochromocytoma and normal adrenal medulla. There was a positive correlation between the expression of HPA and VEGF in pheochromocytoma. Conclusion HPA and VEGF are expected to be indicators of malignant pheochromocytoma.