Department of Pathology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2010 Nov;13(6):498-503.
Tumor growth depends on vascular blood supply. The novel discovery of non-endothelialized vessel-like channels in malignant tumors called vasculogenic mimicry has provided new insights about tumor behavior and also serves as a potential target for drug therapy. Although the association between vasculogenic mimicry and poor prognosis has been established in some tumors, there are only a few studies concerning prostatic carcinoma.
Using a histochemical and immunohistochemical dual staining method for PAS-CD34 and special immunohistochemical staining for laminin, we studied the presence and pattern of non-endothelialized channels known as vasculogenic mimicry as well as the quantity of endothelialized vessels designated as microvessel density in usual paraffin sections of 20 low-grade and 20 high-grade prostatic adenocarcinomas by routine light microscopy.
We found a direct positive relationship between higher microvessel density and tumor grade (P<0.001), presence of vascular invasion (P<0.001) and percent of involved tissue (P<0.001); however, no such relationship was found with vasculogenic mimicry and only a weak correlation was noted between vasculogenic mimicry and perineurial invasion (P=0.03).
Unlike other cancers and despite the results of in vitro studies on prostatic adenocarcinoma, we were not able to demonstrate a significant relationship between vasculogenic mimicry channels and histologic grading as one of the most important prognostic factors; however, this may be due to an inherent limitation of prostatic tissue imposed by abundant smooth muscle fibers stained by this method. On the other hand, microvessel density scoring appears to be an important, simple, and applicable histologic tool for prostatic cancer evaluation in daily practice.
肿瘤的生长依赖于血管的血液供应。在恶性肿瘤中发现了一种新型的非内皮细胞血管样通道，称为血管生成拟态，这为肿瘤行为提供了新的认识，也为药物治疗提供了潜在的靶点。虽然在一些肿瘤中已经确立了血管生成拟态与预后不良之间的关系，但关于前列腺癌的研究很少。
我们使用 PAS-CD34 的组织化学和免疫组织化学双重染色法以及层粘连蛋白的特殊免疫组织化学染色法，在 20 例低级别和 20 例高级别前列腺腺癌的常规石蜡切片中，通过常规光镜研究了已知的非内皮细胞通道（称为血管生成拟态）的存在和模式以及内皮细胞化血管（称为微血管密度）的数量。
我们发现微血管密度与肿瘤分级呈正相关（P<0.001），与血管侵犯（P<0.001）和受累组织百分比（P<0.001）呈正相关；然而，我们没有发现血管生成拟态与肿瘤分级之间存在直接的关系，而且血管生成拟态与神经周围侵犯之间只有微弱的相关性（P=0.03）。
与其他癌症不同，尽管我们对前列腺腺癌进行了体外研究，但我们未能证明血管生成拟态通道与组织学分级之间存在显著关系，这是最重要的预后因素之一；然而，这可能是由于该方法染色的丰富平滑肌纤维对前列腺组织的固有限制所致。另一方面，微血管密度评分似乎是一种重要、简单且适用于前列腺癌评估的组织学工具。
