Gadducci Angiolo, Viacava Paolo, Cosio Stefania, Fanelli Giovanni, Fanucchi Antonio, Cecchetti Denise, Cristofani Renza, Genazzani Andrea Riccardo
Department of Procreative Medicine, Division of Gynecology and Obstetrics, University of Pisa, Via Roma 67, 56127 Pisa, Italy.
Anticancer Res. 2003 Jan-Feb;23(1B):549-56.
The aim of this study was to assess intratumoral microvessel density (IMD) in tissue samples from primary ovarian carcinomas, and to correlate this angiogenic parameter with the common clinico-pathological variables, response to chemotherapy and prognosis of patients with this malignancy.
The investigation was conducted on 64 patients who underwent initial surgery for FIGO stages I-IV ovarian carcinoma. Paraffin-embedded sections of primary tumor specimens were analyzed for IMD by immunohistochemistry using anti-CD34 antibodies. In detail, we assessed the 49 patients with advanced (FIGO stages II-IV) disease. Postoperative chemotherapy consisted of paclitaxel/platinum-based chemotherapy in 36 (73.5%) patients and platinum-based chemotherapy in 13.
The IMD ranged from 6 to 115 microvessels/field, with a median value of 40, and correlated with none of the common clinico-pathological variables of ovarian carcinoma. As for the patients with advanced disease, women with elevated IMD (> or = 40 microvessels/field) had a higher chance of achieving a complete response to chemotherapy when compared to those with lower IMD (p = 0.0068). Multiple logistic regression showed that IMD was an independent predictor of complete response to chemotherapy (p = 0.0094). By log-rank test, patients with elevated IMD had a better progression-free survival (p = 0.0039) and a better overall survival (p = 0.0365) when compared to those with lower IMD. The Cox model showed that IMD was the only independent prognostic variable for both progression-free survival (p = 0.0112) and overall survival (p = 0.0296).
The present retrospective analysis seems to show a positive association between IMD, response to chemotherapy, mainly represented by a paclitaxel/platinum-based regimen, and clinical outcome of patients with advanced ovarian carcinoma.
本研究旨在评估原发性卵巢癌组织样本中的肿瘤内微血管密度（IMD），并将这一血管生成参数与常见的临床病理变量、化疗反应以及该恶性肿瘤患者的预后相关联。
对64例接受国际妇产科联盟（FIGO）I-IV期卵巢癌初次手术的患者进行了调查。使用抗CD34抗体通过免疫组织化学分析原发性肿瘤标本的石蜡包埋切片以检测IMD。具体而言，我们评估了49例晚期（FIGO II-IV期）疾病患者。36例（73.5%）患者术后化疗采用紫杉醇/铂类化疗方案，13例采用铂类化疗方案。
IMD范围为6至115个微血管/视野，中位数为40，且与卵巢癌的常见临床病理变量均无相关性。对于晚期疾病患者，IMD升高（≥40个微血管/视野）的女性与IMD较低的女性相比，化疗完全缓解的机会更高（p = 0.0068）。多因素逻辑回归显示IMD是化疗完全缓解的独立预测因素（p = 0.0094）。通过对数秩检验，与IMD较低的患者相比，IMD升高的患者无进展生存期更好（p = 0.0039），总生存期也更好（p = 0.0365）。Cox模型显示IMD是无进展生存期（p = 0.0112）和总生存期（p = 0.0296）的唯一独立预后变量。
本回顾性分析似乎显示IMD、主要以紫杉醇/铂类方案为代表的化疗反应与晚期卵巢癌患者的临床结局之间存在正相关。
