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目的:观察不同来源的脊柱转移肿瘤组织内Id-1、血管内皮生长因子(VEGF)及微血管密度(MVD)分布情况,探讨其与肿瘤来源及临床术中出血量的关系。方法:选取河北医科大学第四医院病理科2005年1月～2008年7月手术切除并经病理证实为脊柱转移瘤的石蜡包埋标本32例,术中出血量以病例实际记录为准,分为低、中、高出血量组,依据脊柱转移瘤来源分为上皮来源组和间叶组织来源组。采用免疫组化方法检测Id-1、VEGF和CD34(微血管标记)在32例脊柱转移瘤组织中的表达,分析各指标与手术术中出血量及肿瘤来源的关系。结果:Id-1与肿瘤来源有明显相关性,并与临床术中出血量呈正相关(P<0.05);不同来源的转移瘤中VEGF表达量不同,并与临床术中出血量呈正相关(P<0.05);MVD在不同来源的转移瘤中比较没有统计学意义(P>0.05)。不同来源的脊椎转移瘤术中出血量比较,有统计学意义(P<0.05)。结论:Id-1、VEGF在不同来源的脊柱转移瘤中的表达量具有明显区别,且与术中出血量呈正相关;上皮来源的脊柱转移瘤术中出血量大于间叶来源组。不同来源的脊柱转移瘤中,微血管密度无明显不同。
OBJECTIVE: To observe the distribution of Id-1, VEGF and MVD in spine metastasis from different origins, and to explore the relationship between Id-1, the origin of tumor and the amount of bleeding during clinical operation. Methods: Thirty-two paraffin-embedded specimens of pathologically confirmed spinal metastases which were removed surgically from January 2005 to July 2008 in Department of Pathology, the Fourth Hospital of Hebei Medical University were selected. The intraoperative blood loss was based on the actual records of the cases For low, medium and high bleeding group, according to the origin of spinal metastases into epithelial source group and mesenchymal source group. The expressions of Id-1, VEGF and CD34 (microvessel marker) in 32 cases of spinal metastases were detected by immunohistochemistry. The relationship between the indexes and the amount of bleeding during operation and the origin of tumors were analyzed. Results: There was a significant correlation between Id-1 and the source of tumor, and there was a positive correlation between Id-1 and the clinical intraoperative blood loss (P <0.05). The expression of VEGF in different origins of metastatic tumors was different <0.05). MVD was not statistically significant in metastases from different origins (P> 0.05). The amount of bleeding in spine metastases from different sources was statistically significant (P <0.05). Conclusions: The expression of Id-1 and VEGF in spine metastases from different origins is significantly different, and it is positively correlated with the amount of bleeding during operation. The amount of bleeding in epithelial-derived spinal metastases is higher than that in mesenteric origin. Spinal metastases from different sources, no significant difference in microvessel density.