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目的探讨检测微淋巴管、微淋巴管密度(LMVD)和血管内皮生长因子C(VEGF-C)的表达对结直肠癌的临床意义。方法应用5′-核苷酸酶(5′-Nase)组织化学、SABC免疫组织化学(免疫组化)和RT-PCR检测80例结直肠癌组织和癌旁组织及30例结直肠正常组织的微淋巴管、LMVD和VEGF-C的表达,并随访、记录患者的临床病理参数和生存资料,分析其相关性。结果(1)结直肠癌、癌旁、正常结直肠组织的微淋巴管均被染成棕黄褐色。结直肠癌组织微淋巴管管腔封闭或无腔,为无功能淋巴管；癌旁组织微淋巴管丰富,管腔大,为功能性淋巴管。(2)癌旁组织LMVD为9．76±2．85,明显高于结直肠正常组织的5．49±．43(t=8．220,P＜0．01)；也高于癌组织的2．13±0．96(t= 15．118,P＜0．001)。(3)结直肠癌VEGF-C蛋白表达阳性率(48．8%)和相对表达量(1．09±1．20)明显高于正常结直肠组织(0和0),与VEGF-C mRNA表达一致；且VEGF-C表达与LMVD相关。(4) LMVD、VEGF-C表达与结直肠癌患者的年龄、性别、肿瘤部位大小、大体组织学类型无关(均P＞0．05)；与Dukes分期(P＜0．0001、P=0．0234)、淋巴结转移(P＜0．0001、P=0．0059)和生存期(P＜0．0001、P＜0．0001)密切相关。LMVD还与分化程度(P=0．0168)和肝肺血行转移(P=0．0088)相关。结论结直肠癌癌旁微淋巴管为功能性淋巴管；癌旁的功能性微淋巴管和增高的LMVD及肿瘤VEGF-C表达,可作为结直肠癌淋巴管生成的形态学特征、分子表型和判断结直肠癌患者淋巴转移及预后的重要指标。
Objective To investigate the clinical significance of detection of lymphatic vessel, lymphatic vessel density (LMVD) and vascular endothelial growth factor C (VEGF-C) expression in colorectal cancer. Methods The 5’-Nase histochemistry, SABC immunohistochemistry (IHC) and RT-PCR were used to detect 80 colorectal cancer tissues and adjacent normal tissues and 30 normal colorectal tissues Lymphatic vessels, LMVD and VEGF-C expression, and follow-up, record the patient’s clinical pathological parameters and survival data, analyze the correlation. Results (1) Colorectal cancer, paracancerous, normal colorectal lymphatic tissue were dyed brown brown. Colorectal cancer tissue lymphatic lumen closed or no cavity, non-functioning lymphatic vessels; para-cancer tissue rich in lymphatic vessels, large lumen, as a functional lymphatic vessels. (2) The paracancerous tissue LMVD was 9.76 ± 2.85, which was significantly higher than the normal colorectal tissue of 5.49 ±. 43 (t = 8.220, P <0.01), but also higher than that of cancer tissues (2.13 ± 0.96, t = 15.118, P <0.001). (3) The positive expression rate of VEGF-C protein (48.8%) and the relative expression level (1.09 ± 1.20) in colorectal cancer were significantly higher than those in normal colorectal tissues (0 and 0) Consistent expression; and VEGF-C expression associated with LMVD. (4) The expressions of LMVD and VEGF-C were not correlated with the age, sex, tumor size and gross histological type in patients with colorectal cancer (all P> 0.05) .0234), lymph node metastasis (P <0.0001, P = 0.0059) and survival (P <0.0001, P <0.0001). LMVD was also associated with the degree of differentiation (P = 0.0168) and hepatic and hematogenous metastasis (P = 0.0088). Conclusion The expression of lymphangiogenesis in colorectal cancer is a functional lymphatic vessel. The expression of VEGF-C and functional lymphangioadenocarcinoma adjacent to the tumor and VEGF-C expression in colorectal cancer can be used as morphological features and molecular phenotype of lymphangiogenesis in colorectal cancer And to determine the important indicators of lymph node metastasis and prognosis of patients with colorectal cancer.