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目的研究胃癌血管浸润与肿瘤血管形成和转移之间的关系。方法回顾性分析366例胃癌血管浸润与临床病理及预后的关系,并采用免疫组化LSAB法对胃癌组织中血管内皮生长因子(VEGF)、P53蛋白表达及微血管密度进行检测,探讨血管浸润与VEGF和P53蛋白表达及微血管密度之间的相关性。结果31.4%(115/366)的胃癌伴有血管浸润,血管浸润与肿瘤浸润深度、淋巴结转移和肝转移相关,淋巴管浸润和淋巴结转移率随血管浸润加重而增加。VEGF和P53蛋白的高表达率及高微血管密度与血管浸润的程度有关,在有血管浸润的胃癌中,VEGF和P53蛋白表达之间也具有相关性。多因素分析表明,VEGF表达是血管浸润的一个独立危险因子。生存率分析提示,在有血管浸润的胃癌,血管浸润愈严重,预后愈差。结论以血管浸润为特征的胃癌具有较多的血管生成和远处转移,VEGF和P53蛋白表达与血管生成之间具有相关性。
Objective To study the relationship between vascular infiltration of gastric cancer and tumor angiogenesis and metastasis. Methods We retrospectively analyzed the relationship between vascular invasion, clinical pathology and prognosis in 366 cases of gastric cancer. Immunohistochemical LSAB was used to detect the expression of vascular endothelial growth factor (VEGF), P53 protein and microvessel density in gastric cancer tissues. Correlation with P53 protein expression and microvessel density. Results 31.4% (115/366) of gastric cancers had vascular infiltration, vascular infiltration was related to depth of tumor invasion, lymph node metastasis and hepatic metastasis. Lymphatic infiltration and lymph node metastasis rate increased with the infiltration of blood vessels. The high expression rate of VEGF and P53 protein and the high microvessel density are related to the degree of vascular invasion. In vascular invasive gastric cancer, there is a correlation between the expression of VEGF and P53 protein. Multivariate analysis showed that VEGF expression is an independent risk factor for vascular invasion. Survival analysis suggests that in vascular invasive gastric cancer, the more invasive blood vessels, the worse the prognosis. Conclusion Gastric cancer characterized by vascular invasion has more angiogenesis and distant metastasis, and there is a correlation between VEGF and P53 protein expression and angiogenesis.