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目的探讨人巨噬细胞金属弹力酶(HME)对胃癌微血管生成及血管内皮生长因子(VEGF)表达的影响,评价其对预后的意义。方法收集术后病理证实胃癌并获得随访,有完整蜡块资料的65例患者,分别进行免疫组化和原位杂交分析,分析 HME 在胃癌组织中的表达与胃癌微血管密度(MVD)及 VEGF 表达之间的关系;通过生存分析及风险模型评估 HME 表达对胃癌预后的影响。结果在胃癌组织中,HME 高表达与肿瘤血管低密度呈显著相关(P<0.01),HME 与 VEGF 表达呈负相关(P<0.01)。影响胃癌组织 MVD 的多因素分析结果表明,HME 及 VEGF 表达均为胃癌组织 MVD 的独立影响因素(P<0.05),HME 表达与 MVD 呈负相关,VEGF 表达与 MVD 呈正相关,HME 表达可作为肿瘤组织 MVD 的预测指标。胃癌术后生存5年以上者 HME 表达率明显高于术后5年内复发死亡者(P<0.05),而 VEGF 表达情况与此相反。影响胃癌预后的多因素分析结果同样显示,HME 高表达者预后较好,VEGF 高表达者预后较差。结论 HME 高表达与胃癌组织低血管密度及较好的预后密切相关,对抑制肿瘤血管形成、提高生存率起重要作用,可能成为预测胃癌 MVD、判断预后的有效指标,而 VEGF表达起着相反的作用,两者间的平衡可能调控着肿瘤中新生血管的生成并因此影响疾病的预后。
Objective To investigate the effect of human macrophage metalloelastase (HME) on the angiogenesis and the expression of vascular endothelial growth factor (VEGF) in gastric cancer and to evaluate its significance on prognosis. Methods Sixty-five patients with complete paraffin section were collected and pathologically confirmed gastric cancer were followed up for immunohistochemistry and in situ hybridization. The expression of HME in gastric carcinoma and the expression of VEGF and MVD The relationship between HME expression and prognosis of gastric cancer was evaluated by survival analysis and risk model. Results The high expression of HME in gastric cancer tissues was significantly correlated with the low density of tumor vessels (P <0.01), but negatively correlated with the expression of HME (P <0.01). Multivariate analysis showed that both HME and VEGF expression were independent factors of MVD in gastric cancer (P <0.05), HME expression was negatively correlated with MVD, VEGF expression was positively correlated with MVD, and HME expression could be used as tumor Predictors of MVD. The HME expression rate of gastric cancer survived for more than 5 years was significantly higher than that of recurrence within 5 years (P <0.05), while the expression of VEGF was opposite. The multivariate analysis of the prognosis of gastric cancer also showed that the high expression of HME had better prognosis and the high expression of VEGF was associated with poor prognosis. Conclusion HME overexpression is closely related to the low blood vessel density and good prognosis of gastric cancer tissue, which may play an important role in inhibiting tumor angiogenesis and improving survival rate. It may be an effective indicator to predict MVD and prognosis of gastric cancer, while VEGF expression is opposite The balance between the two may regulate the formation of neovascularization in the tumor and thus affect the prognosis of the disease.