Sun Baocun, Zhang Shiwu, Zhang Danfang, Du Jing, Guo Hua, Zhao Xiulan, Zhang Wei, Hao Xishan
Department of Pathology, Tianjin Cancer Hospital, Tianjin Medical University, Tianjin 300060, P.R. China.
Oncol Rep. 2006 Oct;16(4):693-8.
Vasculogenic mimicry (VM) has increasingly been recognized as a form of angiogenesis. In VM, epithelial cells are integrated into the malignant tumor vasculature. An association has been observed between VM and poor clinical prognosis in some malignant tumors. However, whether VM is present and clinically significant in hepatocellular carcinoma (HCC) is unknown. In this study, we determined whether VM was present in HCC and whether it was associated with tumor grade, invasion and metastasis, and survival duration. We collected paraffin-embedded HCC tumor samples, along with complete clinical and pathologic data for all the cases, and performed immunohistochemical staining for CD31, CD105 (endoglin), hepatocyte, vascular endothelial growth factor, matrix metalloproteinase (MMP)-2, and MMP-9. The VM status was compared with the clinical and pathological data using statistical tests. Kaplan-Meier survival analysis and log-rank test were used to compare survival durations between patients with and without VM. The VM vessel cells were CD31 and CD105-negative and hepatocyte and vascular endothelial growth factor-positive, showing that they were not derived from endothelial cells but were HCC tumor cells. Patients with VM had a higher metastasis rate than did those without VM (P=0.003). Consistent with this finding, MMP-2 and MMP-9 were present in all the VM cases but were found less frequently in non-VM cases (P<0.05). The Kaplan-Meier survival analysis showed that patients in the VM group had a significantly shorter survival duration than did those in the non-VM group. In conclusion, VM is a marker of poor clinical prognosis in HCC: Its presence may be associated with a high tumor grade, invasion and metastasis, and short survival.
血管生成拟态（VM）已越来越多地被视为一种血管生成形式。在VM中，上皮细胞整合到恶性肿瘤脉管系统中。在一些恶性肿瘤中，已观察到VM与不良临床预后之间存在关联。然而，VM在肝细胞癌（HCC）中是否存在及其临床意义尚不清楚。在本研究中，我们确定了VM在HCC中是否存在，以及它是否与肿瘤分级、侵袭和转移以及生存时间相关。我们收集了石蜡包埋的HCC肿瘤样本以及所有病例的完整临床和病理数据，并对CD31、CD105（内皮糖蛋白）、肝细胞、血管内皮生长因子、基质金属蛋白酶（MMP）-2和MMP-9进行了免疫组化染色。使用统计检验将VM状态与临床和病理数据进行比较。采用Kaplan-Meier生存分析和对数秩检验比较有VM和无VM患者的生存时间。VM血管细胞CD31和CD105阴性，肝细胞和血管内皮生长因子阳性，表明它们不是来源于内皮细胞，而是HCC肿瘤细胞。有VM的患者转移率高于无VM的患者（P=0.003）。与此发现一致的是，所有VM病例中均存在MMP-2和MMP-9，但在非VM病例中较少见（P<0.05）。Kaplan-Meier生存分析表明，VM组患者的生存时间明显短于非VM组。总之，VM是HCC不良临床预后的一个标志物：它的存在可能与高肿瘤分级、侵袭和转移以及短生存期相关。
