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目的探讨血管生成与原发性肝细胞癌进展的关系。方法收集1993年～2000年41例病人的手术切除病理证实与原发性肝细胞癌的标本,行免疫组化染色(SABC法)检测血管内皮生长因子(VEGF)的表达以及肿瘤组织和肿瘤旁组织的微血管密度(MVD)。其中男34例,女7例;年龄35￣65岁,平均48.8岁;肿瘤直径≤5cm者13例,>5cm者28例,有包膜者19例,无包膜者22例。细胞学分级:Ⅰ级8例,Ⅱ级18例,Ⅲ级11例,Ⅳ级4例。门静脉或(和)肝静脉有癌栓形成者7例,无癌栓者34例。HbsAg或HBcAb阳性者33例,阴性者8例。结果VEGF表达阳性率为70.7%(29/41)。VEGF的表达与MVD呈显著正相关(P<0.01)。VEGF的阳性表达率与肿瘤病灶大小、有无静脉癌栓呈显著相关,肿瘤直径大、病期晚者表达率显著增高(P<0.05或0.01)。有包膜的肿瘤VEGF表达率显著低于无包膜者。VEGF的表达与细胞学分级和是否有肝炎病毒感染无显著性相关。结论肝细胞癌中VEGF的分泌增多可导致微血管数目增加,促进了其进展和转移。肿瘤较大、分期较晚的病例血管生成活性高,提示预后较差。
Objective To investigate the relationship between angiogenesis and progression of primary hepatocellular carcinoma. Methods 41 patients with pathologically confirmed primary hepatocellular carcinoma (HCC) were collected from 1993 to 2000. The expression of vascular endothelial growth factor (VEGF) and the expression of vascular endothelial growth factor (VEGF) were detected by immunohistochemical staining (SABC) Tissue microvessel density (MVD). There were 34 males and 7 females, aged from 35 to 65 years, with an average of 48.8 years. Of the 13 patients with tumor diameter ≤ 5 cm, 28 were> 5 cm, 19 with capsule and 22 without capsule. Cytology grade: Ⅰ grade in 8 cases, Ⅱ grade in 18 cases, Ⅲ grade in 11 cases, Ⅳ grade in 4 cases. Portal vein or (and) hepatic vein with thrombosis in 7 cases, 34 cases without tumor emboli. 33 cases were positive for HBsAg or HBcAb, and 8 cases were negative. Results The positive rate of VEGF expression was 70.7% (29/41). The expression of VEGF was positively correlated with MVD (P <0.01). The positive expression rate of VEGF was significantly correlated with tumor size and presence or absence of venous thrombosis. The tumor diameter was large and the expression rate of late stage was significantly higher (P <0.05 or 0.01). The VEGF expression rate of the tumor with capsule was significantly lower than those without capsule. VEGF expression and cytological grading and whether there is no significant correlation between hepatitis virus infection. Conclusion The increased secretion of VEGF in hepatocellular carcinoma can lead to an increase in the number of microvessels and promote their progression and metastasis. Larger tumors and later stages of angiogenesis activity, suggesting that the prognosis is poor.