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目的分析中下段直肠癌血管内皮生长因子(VEGF)表达状况与临床病理特征的关系,初步探讨中下段直肠癌淋巴结微转移的分子机制。方法应用CK-20免疫组化技术对56例中下段直肠癌患者共计661枚淋巴结检测微转移,同时检测肿瘤组织中VEGF表达情况。结果57.1%(32/56)中下段直肠癌VEGF表达阳性;T3直肠癌VEGF表达阳性率为74.1%,明显高于T2和T1直肠癌的43.5%和33.3%(P=0.043);淋巴结转移阳性的中下段直肠癌VEGF表达阳性率为72.4%,明显高于淋巴结转移阴性的40.7%(P=0.017);20例(35.7%)中下段直肠癌患者67枚(10.1%)淋巴结检出微转移,该20例检测出淋巴结微转移的癌组织中15例(75%)VEGF表达阳性,而36例未检测出淋巴结微转移的癌组织中仅有17例(47.2%)VEGF表达阳性,(P=0.044)。结论中下段直肠癌VEGF表达状况与浸润深度和淋巴结转移密切相关,VEGF可能参与中下段直肠癌淋巴结微转移的发生。
Objective To analyze the relationship between the expression of vascular endothelial growth factor (VEGF) and clinicopathological features in the middle and lower rectal cancer and to explore the molecular mechanism of lymph node micrometastasis in the middle and lower rectal cancer. Methods A total of 661 lymph node micrometastases in 56 patients with rectal cancer were detected by CK-20 immunohistochemistry. Meanwhile, VEGF expression in tumor tissue was detected. Results The positive rate of VEGF in rectal cancer was 57.1% (32/56). The positive rate of VEGF in T3 rectal cancer was 74.1%, significantly higher than that in T2 and T1 rectal cancer (43.5% and 33.3%, P = 0.043). The positive lymph node metastasis The positive rate of VEGF in the middle and lower rectum was 72.4%, which was significantly higher than that in the negative lymph node (40.7%) (P = 0.017). The micrometastasis was detected in 67 (10.1%) of the 20 patients (35.7% , VEGF expression was positive in 15 of 20 (75%) cancerous tissues with lymph node micrometastases detected, and only 17 (47.2%) of 36 cancerous tissues without lymph node micrometastasis were positive in VEGF expression (P = 0.044). Conclusion The expression of VEGF in the middle and lower rectal cancer is closely related to the depth of invasion and lymph node metastasis. VEGF may be involved in the lymph node micrometastasis in the rectal cancer.