早期胃癌的瘤内新生血管形成及生长模式

Intratumoral neovascularization and growth pattern in early gastric carcinoma.

作者信息

Tomoda M, Maehara Y, Kakeji Y, Ohno S, Ichiyoshi Y, Sugimachi K

机构信息

Department of Surgery II, Kyushu University Faculty of Medicine, Fukuoka, Japan.

出版信息

Cancer. 1999 Jun 1;85(11):2340-6. doi: 10.1002/(sici)1097-0142(19990601)85:11<2340::aid-cncr7>3.0.co;2-i.

DOI:10.1002/(sici)1097-0142(19990601)85:11<2340::aid-cncr7>3.0.co;2-i

PMID:10357403

Abstract

BACKGROUND

The growth pattern of early gastric carcinoma, based on a volumetric analysis, reflects biologic characteristics of the tumor. The authors investigated the microvessel density (MVD), expression of vascular endothelial growth factor (VEGF), and growth patterns in early gastric carcinoma.

METHODS

Ninety-four tissue specimens resected from patients with early gastric carcinoma invading the submucosal layer were examined. Microvessel quantification was performed immunohistochemically using a monoclonal antibody against factor VIII-related antigen. VEGF expression was studied using an anti-VEGF polyclonal antibody. Growth patterns were defined as follows: Pen A type: expansively penetrating growth; Pen B type: infiltratively penetrating growth; Super type: superficially spreading growth.

RESULTS

The mean MVD was 16.9 (range, 5.2-43.0). MVD was significantly higher in tumors with venous invasion (P<0.01), lymphatic vessel invasion (P<0.05), and lymph node metastases (P<0.05) compared with MVD in tumors without venous or lymphatic vessel invasion or lymph node metastases. The VEGF-positive rate of Pen A type tumors was 66.7% (18 of 27), that Pen B type was 10.0% (1 of 10), that of Super type was 19.4% (6 of 31), and that of the unclassified type was 15.4% (4 of 26). The VEGF-positive rate in patients with Pen A type tumors was significantly higher than that in patients with the other three growth patterns(P<0.01). MVD in patients with Pen A type tumors (25.9+/-9.2) was significantly higher than that in patients with Super type tumors (12.6+/-5.4) (P<0.01). Patients with Pen A type tumors had a poorer prognosis than patients whose tumors had other growth patterns (P<0.05). According to multivariate analysis, VEGF expression and lymphatic vessel invasion were significant prognostic factors.

CONCLUSIONS

Pen A type gastric carcinoma tends to secrete VEGF, thus inducing tumor angiogenesis and resulting in venous invasion. Intensive follow-up is necessary for patients with Pen A type tumors, because this tumor type has a greater propensity for hematogenous metastasis.

摘要

背景

基于容积分析的早期胃癌生长模式反映了肿瘤的生物学特性。作者研究了早期胃癌的微血管密度（MVD）、血管内皮生长因子（VEGF）的表达及生长模式。

方法

对94例侵犯黏膜下层的早期胃癌患者切除的组织标本进行检查。采用抗VIII因子相关抗原单克隆抗体，通过免疫组织化学方法进行微血管定量分析。使用抗VEGF多克隆抗体研究VEGF表达情况。生长模式定义如下：Pen A型：膨胀性浸润生长；Pen B型：浸润性浸润生长；Super型：浅表扩散生长。

结果

平均MVD为16.9（范围5.2 - 43.0）。与无静脉或淋巴管侵犯及无淋巴结转移的肿瘤相比，有静脉侵犯（P<0.01）、淋巴管侵犯（P<0.05）及淋巴结转移（P<0.05）的肿瘤MVD显著更高。Pen A型肿瘤的VEGF阳性率为66.7%（27例中的18例），Pen B型为10.0%（10例中的1例），Super型为19.4%（31例中的6例），未分类型为15.4%（26例中的4例）。Pen A型肿瘤患者的VEGF阳性率显著高于其他三种生长模式的患者（P<0.01）。Pen A型肿瘤患者的MVD（25.9±9.2）显著高于Super型肿瘤患者（12.6±5.4）（P<0.01）。Pen A型肿瘤患者的预后比肿瘤具有其他生长模式的患者差（P<0.05）。多因素分析显示，VEGF表达和淋巴管侵犯是重要的预后因素。