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目的探讨血管生成类标志物VEGF(vascular endothelial growth factor,VEGF)、Flt-1[fms-related tyrosine kinase 1(fms相关酪氨酸激酶1),Flt-1,也称作VEGFR-1]、PIGF(placenta growthfactor,PIGF)与非小细胞肺癌(non-small cell lung cancer,NSCLC)脉管瘤栓(blood vessel invasion,BVI)的关系以及与NSCLC预后的相关性。方法1997年3月至2002年3月间我院胸外科行根治性手术治疗的NSCLC患者1 826例,随机选择有脉管瘤栓者27例(有脉管瘤栓者共126例),并随机抽取无脉管瘤栓者33例,两组患者共60例。采用免疫组化方法研究三种血管生成类标记物(VEGF、Flt-1、PIGF)在NSCLC中的表达以及与脉管瘤栓的相关性,将可能影响NSCLC预后的风险因子进行单因素分析,寻找与肺癌预后相关的因素,用Cox多元回归法确定影响NSCLC预后的风险因素。结果VEGF在NSCLC中的阳性表达率为51.2%,Flt-1阳性表达率为47.6%,PIGF阳性表达率为13.3%。在VEGF阳性表达者中,有脉管瘤栓组占74.2%(23/31),而在VEGF阴性表达者有脉管瘤栓组占13.4%(4/29,P<0.05);Flt-1阳性表达者在有脉管瘤栓组占64.3%(18/28),而Flt-1阴性表达者在有脉管瘤栓组占28.1%(9/32,P<0.05);在有脉管瘤栓组PIGF阳性表达者占100%(8/8),而在PIGF阴性表达者有脉管瘤栓组占36.5%(19/52,P<0.05)。VEGF、Flt-1、PIGF均与脉管瘤栓有显著相关性(P<0.05)。Flt-1的表达与病理类型有关,Flt-1在肺腺癌中的表达为79.2%。单因素分析发现,脉管瘤栓(P<0.001)、Flt-1(P<0.001)、VEGF(P<0.001)与肺癌预后明显相关。结论VEGF、Flt-1、PIGF与非小细胞肺癌脉管瘤栓显著相关,Flt-1与肺腺癌密切相关。脉管瘤栓、VEGF、Flt-1是影响NSCLC预后的重要因素。
Objective To investigate the expression of vascular endothelial growth factor (VEGF), Flt-1 [fms-related tyrosine kinase 1], Flt-1, also known as VEGFR- To investigate the relationship between placenta growth factor (PIGF) and non-small cell lung cancer (NSCLC) blood vessel invasion (BVI) and the prognosis of NSCLC. Methods A total of 1 826 NSCLC patients undergoing radical surgery in our department from March 1997 to March 2002 were randomly divided into 27 cases (126 cases with vascular tumor suppository) with vascular tumor thrombus and Totally 33 patients without vascular tumor suppository were selected, 60 patients in both groups. The expression of three angiogenic markers (VEGF, Flt-1, PIGF) in NSCLC and the correlation with the vascular tumor thrombus were studied by immunohistochemistry. The risk factors that may affect the prognosis of NSCLC were analyzed by univariate analysis. Finding out the factors related to the prognosis of lung cancer and using Cox multivariate regression to determine the risk factors that affect the prognosis of NSCLC. Results The positive rate of VEGF in NSCLC was 51.2%, the positive rate of Flt-1 was 47.6%, and the positive rate of PIGF was 13.3%. Among the VEGF-positive patients, 74.2% (23/31) had vascular tumor thrombus and 13.4% (4/29, P <0.05) had vascular thrombosis in those with negative VEGF; Flt-1 The positive expression rate was 64.3% (18/28) in patients with vascular tumor thrombus, and 28.1% (9/32, P <0.05) in those with Flt-1 negative tumor; The PIGF positive expression rate was 100% (8/8) in the tumor suppository group and 36.5% (19/52, P <0.05) in the PIGF negative group. VEGF, Flt-1, PIGF were significantly associated with vascular tumor thrombus (P <0.05). The expression of Flt-1 was related to the pathological type. The expression of Flt-1 in lung adenocarcinoma was 79.2%. Univariate analysis showed that there were significant correlations between angioma suppository (P <0.001), Flt-1 (P <0.001), VEGF (P <0.001) and lung cancer prognosis. Conclusions VEGF, Flt-1, PIGF are significantly associated with non-small cell lung cancer with tumor thrombus, and Flt-1 is closely related with lung adenocarcinoma. Vascular tumor thrombus, VEGF, Flt-1 are important factors affecting the prognosis of NSCLC.