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目的探讨非小细胞肺癌(NSCLC)患者淋巴管生成(lymphangiogenesis)与预后的关系。方法应用免疫组织化学的方法,检测68例NSCLC和8例肺炎症性肌纤维母细胞瘤(PIMT)组织标本中CD31、podoplanin和血管内皮生长因子受体-3(VEGFR-3)的表达,进行淋巴管密度及微血管密度计数;与血管内皮标志物CD31比较,评价VEGFR-3和podoplanin标志物的表达;分析淋巴管密度与患者临床病理改变及预后的关系。结果Podoplanin阳性淋巴管密度与CD31阳性血管密度、VEGFR-3阳性血管密度无相关性;VEGFR-3与CD31阳性血管密度有相关性。镜下见VEGFR-3阳性管多数有血管,而podoplanin阳性管未发现血管。淋巴管密度在NSCLC组为(22.4±8.6)支/mm2,明显高于PIMT组的(10.9±4.9)支/mm2;与淋巴结转移阴性组[(20.4±8.2)支/mm2]比较,淋巴结转移阳性组淋巴管密度[(24.8±9.0)支/mm2]明显增高;临床Ⅲ+Ⅳ期患者组织淋巴管密度[(27.2±9.2)条/mm2]明显高于Ⅰ+Ⅱ期的(19.5±6.9)支/mm2;淋巴管密度与NSCLC的组织类型、细胞分化、患者的年龄和性别无关。多因素分析结果显示,淋巴管密度是影响NSCLC患者预后的独立危险因素,高淋巴管密度较低淋巴管密度患者预后差。结论Podoplanin是较为特异的淋巴管内皮标志物,淋巴管密度可作为NSCLC患者预后有意义的预测指标之一。
Objective To investigate the relationship between lymphangiogenesis and prognosis in patients with non-small cell lung cancer (NSCLC). Methods The expressions of CD31, podoplanin and vascular endothelial growth factor receptor-3 (VEGFR-3) in 68 cases of NSCLC and 8 cases of pulmonary inflammatory myofibroblastoma (PIMT) were detected by immunohistochemistry. Tube density and microvessel density. Compared with vascular endothelial marker CD31, the expression of VEGFR-3 and podoplanin markers was evaluated. The relationship between lymphatic vessel density and clinical pathological changes and prognosis was analyzed. Results Podoplanin positive lymphatic vessel density and CD31 positive vascular density, VEGFR-3 positive vascular density no correlation; VEGFR-3 and CD31 positive vascular densities were correlated. Microscopically VEGFR-3 positive tube most of the blood vessels, and podoplanin positive tube was not found in blood vessels. Lymphatic vessel density was (22.4 ± 8.6) mm2 / mm2 in NSCLC group, which was significantly higher than that in PIMT group (10.9 ± 4.9) / mm2. Compared with lymph node metastasis negative group (20.4 ± 8.2) / mm2, The density of lymphatic vessels in the positive group was significantly higher than that in the group Ⅰ + Ⅱ ([(24.8 ± 9.0) / mm2]; the lymph node density in the patients with stage Ⅲ + Ⅳ was (27.2 ± 9.2) / mm2] ) Branch / mm2; lymphatic vessel density and NSCLC tissue type, cell differentiation, the patient’s age and gender has nothing to do. Multivariate analysis showed that lymphatic vessel density was an independent risk factor affecting the prognosis of patients with NSCLC. The patients with high lymphatic vessel density had poor prognosis. Conclusion Podoplanin is a more specific endodermal lymphatic marker. Lymphatic vessel density can be used as one of the predictors of the prognosis of NSCLC patients.