Baek Seung-Kuk, Jung Kwang-Yoon, Lee Sang-Hag, Woo Jeong-Soo, Kwon Soon-Young, Chung Eun-Jae, Kim Tae-Hoon, Chae Yang-Seok
Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, South Korea.
Laryngoscope. 2009 Jul;119(7):1325-30. doi: 10.1002/lary.20483.
OBJECTIVES/HYPOTHESIS: Regional lymph node metastases are very common findings of supraglottic cancer. The mechanism of lymphatic metastasis is as yet unknown because there have been no specific markers that could definitely distinguish lymphatic vessels from blood vessels. The aim of this study is to identify the prognostic significance of vascular endothelial growth factor-C (VEGF-C) expression and lymphatic vessel density (LVD) in supraglottic cancer.
The prognostic value of the VEGF-C and LVD was retrospectively evaluated in an unselected series of patients treated with curative intent for supraglottic cancer.
We investigated lymphatic vessels in 43 subjects who had previously been diagnosed with supraglottic cancer. Immunohistochemical staining was performed with VEGF-C, D2-40, and CD31 monoclonal antibodies on the paraffin-embedded tissues obtained from these patients. The association among the semiquantitative score of VEGF-C stained cancer cells, the density of immunohistochemically stained microvessels, and the prognostic factors of supraglottic cancers were investigated to evaluate the prognostic significance.
VEGF-C and LVD showed a statistically significant difference according to the presence of lymph node metastasis and regional recurrence (P < .05). VEGF-C was only associated with disease-free survival and regional recurrence in multivariate analysis (P < .05).
VEGF-C and LVD might be useful as predictors of the risk of lymph node metastasis and regional recurrence.
目的/假设：区域淋巴结转移是声门上型癌非常常见的表现。由于尚无能够明确区分淋巴管与血管的特异性标志物，淋巴转移的机制尚不清楚。本研究的目的是确定血管内皮生长因子-C（VEGF-C）表达和淋巴管密度（LVD）在声门上型癌中的预后意义。
对一系列未经选择的接受声门上型癌根治性治疗的患者进行回顾性评估，以确定VEGF-C和LVD的预后价值。
我们调查了43例先前被诊断为声门上型癌的患者的淋巴管情况。对从这些患者获取的石蜡包埋组织用VEGF-C、D2-40和CD31单克隆抗体进行免疫组织化学染色。研究VEGF-C染色癌细胞的半定量评分、免疫组织化学染色微血管密度与声门上型癌预后因素之间的关联，以评估其预后意义。
根据有无淋巴结转移和区域复发，VEGF-C和LVD显示出统计学上的显著差异（P < 0.05）。在多变量分析中，VEGF-C仅与无病生存期和区域复发相关（P < 0.05）。
VEGF-C和LVD可能作为淋巴结转移和区域复发风险的预测指标。
