Yu Feng, Jiang Xiao-zhong, Chen Wan-tao, Zhao Yun-fu, Zhou Xiao-jian
Department of Stomatology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Shanghai Kou Qiang Yi Xue. 2003 Dec;12(6):443-6.
To discern whether the microvessel density (MVD) and the expression of vascular endothelial growth factor (VEGF) could be prognostic indicators for the metastasis and survival of patients with SACC after radical surgery.
After the follow-up of 31 primary patients with SACC treated with radical surgeries for at least 60 months, the paraffin-bedded sections of the those patients were stained immunohistochemically with anti-CD34-McAb and anti-VEGF-McAb, respectively. Subsequently, two pathologists double-blindly evaluated the sections stained with anti-CD34-McAb to determine the MVD values individually, as well as, measured the sections stained with the ani-VEGF-McAb to determine the OD values. Consequently the data were analyzed with the statistic software package detailed.
The univariate statistical analysis showed that the pathological types of SACC, the TNM stages, MVD and OD values were all statistically significant variables for the survival of the patients with SACC (P = 0.047, 0.000, 0.000, 0.024). Furthermore, among those reliable variables, only MVD was more significant in the Cox proportional hazard model for the multivariate analyses (P = 0.000). The MVD values were statistically significantly higher, in the group with either death, or metastasis, or tumor-relapse, or worse pathological types, or advanced TNM stages, than their counterparts respectively(P = 0.029, 0.045, 0.019, 0.031, 0.00). On the other hand, the OD values were also statistically significantly higher, in the group with either death, or worse pathological types, or advanced TNM stages, than their counterparts respectively(P = 0.037, 0.013, 0.014). The results of Fisher exact test showed that the incidence of distant metastasis differed statistically significantly between the subgroups divided with the median of the MVD values (P = 0.032). The stepwise linear regression equation showed that the MVD value correlated positively with the OD value (P = 0.029).
The MVD value and the expression level of VEGF all have statistically significant correlations with the survival of the patients with SACC, moreover, the MVD value is more significant as a prognostic indicator. The MVD value could also be a prognostic indicator for the incidence of the distant metastasis of patients with SACC. The over-expression of VEGF in SACC might contribute to the MVD values increasing.
探讨微血管密度（MVD）及血管内皮生长因子（VEGF）表达是否可作为涎腺腺样囊性癌（SACC）患者根治性手术后转移及生存的预后指标。
对31例行根治性手术的原发性SACC患者进行至少60个月的随访，分别用抗CD34单克隆抗体和抗VEGF单克隆抗体对患者石蜡包埋切片进行免疫组织化学染色。随后，两名病理学家对抗CD34单克隆抗体染色的切片进行双盲评估，分别确定MVD值，并对抗VEGF单克隆抗体染色的切片进行测量以确定OD值。最后用详细的统计软件包对数据进行分析。
单因素统计分析显示，SACC的病理类型、TNM分期、MVD和OD值均是SACC患者生存的统计学显著变量（P = 0.047、0.000、0.000、0.024）。此外，在这些可靠变量中，只有MVD在多因素分析的Cox比例风险模型中更显著（P = 0.000）。在死亡、转移、肿瘤复发、病理类型较差或TNM分期较晚的组中，MVD值分别显著高于相应对照组（P = 0.029、0.045、0.019、0.031、0.00）。另一方面，在死亡、病理类型较差或TNM分期较晚的组中，OD值也分别显著高于相应对照组（P = 0.037、0.013、0.014）。Fisher确切概率检验结果显示，以MVD值中位数划分的亚组之间远处转移发生率差异有统计学意义（P = 0.032）。逐步线性回归方程显示，MVD值与OD值呈正相关（P = 0.029）。
MVD值和VEGF表达水平均与SACC患者的生存有统计学显著相关性，而且MVD值作为预后指标更显著。MVD值也可能是SACC患者远处转移发生率的预后指标。SACC中VEGF的过表达可能导致MVD值增加。
