Department of General-, Visceral-, and Thoracic-Surgery, University Medical Center Hamburg Eppendorf, Germany.
Histol Histopathol. 2010 Oct;25(10):1239-46. doi: 10.14670/HH-25.1239.
Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is an increasingly diagnosed entity since its definition by the World Health Organization in 1996. It has a broad clinical spectrum ranging from benign to malignant tumors. Optimum treatment is controversial and a better understanding of the development of IPMN of the pancreas and identification of potential prognostic factors will help to address this. Angiogenesis plays an elementary role in the development of malignant tumors and may well also be important in the development of IPMN of the pancreas. Therefore we investigated endothelial cell marker CD31 (PECAM-1) and angiogenesis associated marker CD105 (endoglin) by immunohistochemistry.
Thirty-two cases of surgically resected IPMN were chosen retrospectively and clinical data were obtained. Specimens were stained for proliferation marker (Ki-67), CD31 and CD105 by immunohistochemistry. A CD105/CD31 Angiogenesis ratio (AR) was established to determine the proliferating fraction of endothelial cells.
The AR is significantly elevated in invasive IPMN of the pancreas (Mann-Whitney-U Test, p<0.05) and is associated with the Ki-67-labelling-index, demonstrating synergy between tumor-growth and neovascularisation. Invasive IPMN of the pancreas is associated with significantly lower recurrence-free and overall survival.
Neovascularisation plays an important role in the tumorigenesis of invasive IPMN of the pancreas, and therefore angiogenesis-associated molecules like CD105 and CD31 might be useful tools as prognostic markers. Furthermore, the results indicate a potential role for adjuvant anti-angiogenic therapies in selected patients with recurring and/or invasive IPMN of the pancreas.
自 1996 年世界卫生组织（WHO）定义以来，胰腺内乳头状黏液性肿瘤（IPMN）的发病率逐渐升高。它具有从良性到恶性肿瘤的广泛临床谱。最佳治疗方法存在争议，更好地了解胰腺 IPMN 的发展和确定潜在的预后因素将有助于解决这一问题。血管生成在恶性肿瘤的发展中起着基本作用，在胰腺 IPMN 的发展中也可能很重要。因此，我们通过免疫组织化学研究了内皮细胞标志物 CD31（PECAM-1）和血管生成相关标志物 CD105（内皮糖蛋白）。
回顾性选择 32 例手术切除的 IPMN 病例，并获得临床数据。标本通过免疫组织化学染色进行增殖标志物（Ki-67）、CD31 和 CD105 的染色。建立 CD105/CD31 血管生成比（AR）以确定内皮细胞的增殖分数。
侵袭性胰腺 IPMN 的 AR 显著升高（Mann-Whitney-U 检验，p<0.05），并与 Ki-67 标记指数相关，表明肿瘤生长和新生血管之间存在协同作用。侵袭性胰腺 IPMN 与无复发生存率和总生存率显著降低相关。
血管生成在侵袭性胰腺 IPMN 的肿瘤发生中起着重要作用，因此，血管生成相关分子如 CD105 和 CD31 可能是作为预后标志物的有用工具。此外，这些结果表明在选择的复发性和/或侵袭性胰腺 IPMN 患者中，辅助抗血管生成治疗可能具有潜在作用。
