Näyhä Veera V, Stenbäck Frej G
Department of Pathology, University of Oulu, Oulu, Finland.
Acta Obstet Gynecol Scand. 2007;86(11):1392-7. doi: 10.1080/00016340701674303. Epub 2007 Oct 16.
Increased angiogenesis is associated with an increased risk of malignant transformation in many organs. The occurrence, characteristics and significance of angiogenesis in vulvar squamous cell carcinoma are less well known.
In this study, vessel number as well as vessel size, vessel shape and vessel antibody staining intensity were determined in 23,091 vessels in CD34-stained histological specimens of 42 patients by computer-assisted quantitative image analysis methods and findings were related to tumor morphology, clinical characteristics and patient survival.
The 2- and 5-year survival rates were 81.1 and 64.1%, respectively. High disease stage and high histological grade indicated poor prognosis. In an age-adjusted multivariate analysis of stage, grade and extent of invasion, these variables compiled a statistically significant prognostic factor (p=0.001). Tumor histopathological type was a prognostic factor in our study and keratinising tumors did significantly better. Large tumor size, but not depth of invasion, and spray type growth pattern also indicated poor survival. In an age-adjusted multivariate analysis of stage, grade and extent of invasion, these variables compiled a statistically significant prognostic factor (p=0.001), but none of these variables alone proved to be an independent prognostic factor. High vessel number and increased vessel size were also significant indicators of poor survival, as were vessel characteristics: vessel number, vessel size, vessel shape and staining intensity together.
Increased angiogenesis and altered vessel characteristics were prognostic factors in determining patient survival in this study. Analysis of angiogenesis provided new information on tumor behaviour and provided markers for survival analysis in neoplasms classified by tumor type and growth pattern.
血管生成增加与许多器官恶性转化风险的增加相关。外阴鳞状细胞癌中血管生成的发生、特征及意义鲜为人知。
在本研究中，通过计算机辅助定量图像分析方法，对42例患者的CD34染色组织学标本中的23,091个血管测定血管数量以及血管大小、血管形状和血管抗体染色强度，并将结果与肿瘤形态、临床特征及患者生存率相关联。
2年和5年生存率分别为81.1%和64.1%。疾病分期高和组织学分级高提示预后不良。在对分期、分级及浸润范围进行年龄校正的多因素分析中，这些变量构成了一个具有统计学意义的预后因素（p = 0.001）。肿瘤组织病理学类型是本研究中的一个预后因素，角化型肿瘤预后明显更好。肿瘤体积大，但浸润深度不是，以及喷雾型生长模式也提示生存率低。在对分期、分级及浸润范围进行年龄校正的多因素分析中，这些变量构成了一个具有统计学意义的预后因素（p = 0.001），但这些变量单独均未被证明是独立的预后因素。血管数量多和血管大小增加也是生存率低的重要指标，血管特征（血管数量、血管大小、血管形状和染色强度）综合起来也是如此。
血管生成增加和血管特征改变是本研究中决定患者生存率的预后因素。血管生成分析为肿瘤行为提供了新信息，并为按肿瘤类型和生长模式分类的肿瘤生存分析提供了标志物。
