Khan A W, Dhillon A P, Hutchins R, Abraham A, Shah S R, Snooks S, Davidson B R
University Department of Surgery, Royal Free & University College Medical School, University College London, UK.
Eur J Surg Oncol. 2002 Sep;28(6):637-44. doi: 10.1053/ejso.2002.1307.
Angiogenesis is required for tumour growth. Its evaluation, by intratumoural microvessel density (IMD), has prognostic significance in many solid tumours. There is controversy regarding its use in pancreatic cancer and little is known about its role in ampullary tumours. The aim is to study IMD as a prognostic marker in resected ductal adenocarcinomas of head of pancreas and cancers of the ampullary region.
Forty-seven patients (23 pancreatic and 24 ampullary, mean age 62.0 years) surviving a potentially curative (R0/R1) resection were analysed. Paraffin-embedded sections of these tumours were immunohistochemically stained for CD-34 and IMD was determined (magnification x200). This was correlated with histopathological data and survival using Cox's multivariate analysis.
Mean survival for the pancreatic cancer group was 18.4 months (SE=2.7) and 81.2 months (SE=9.9) for the ampullary cancer group. In the pancreatic cancer group, IMD was found to have independent prognostic significance to survival on multivariate analysis (P=0.002, Hazard Ratio (HR) 13.60) along with microscopic resection margin involvement (P=0.003, HR 15.18). For ampullary cancers, IMD was higher in those with lymph node metastasis (P=0.02, Mann-Whitney U -test).
IMD in resected pancreatic cancers correlates with survival.
血管生成是肿瘤生长所必需的。通过肿瘤内微血管密度（IMD）对其进行评估，在许多实体瘤中具有预后意义。其在胰腺癌中的应用存在争议，而关于其在壶腹肿瘤中的作用知之甚少。目的是研究IMD作为胰头导管腺癌和壶腹区域癌切除术后的预后标志物。
对47例接受了可能根治性（R0/R1）切除且存活的患者（23例胰腺癌患者和24例壶腹癌患者，平均年龄62.0岁）进行分析。对这些肿瘤的石蜡包埋切片进行CD-34免疫组化染色，并确定IMD（放大倍数×200）。使用Cox多变量分析将其与组织病理学数据和生存率相关联。
胰腺癌组的平均生存期为18.4个月（标准误=2.7），壶腹癌组为81.2个月（标准误=9.9）。在胰腺癌组中，多变量分析显示IMD对生存具有独立的预后意义（P=0.002，风险比（HR）13.60），同时显微镜下切缘受累情况也具有独立预后意义（P=0.003，HR 15.18）。对于壶腹癌，有淋巴结转移者的IMD更高（P=0.02，Mann-Whitney U检验）。
切除的胰腺癌中的IMD与生存率相关。
