Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
Surg Today. 2012 Jan;42(2):169-76. doi: 10.1007/s00595-011-0045-0. Epub 2011 Nov 10.
The roles of angiogenesis and the most prominent angiogenic vascular endothelial growth factor (VEGF) in diseases of the pancreas remain controversial. We compared microvessel density (MVD) and VEGF status in normal pancreatic, chronic pancreatic, and pancreatic cancer (PC) tissues to establish their prognostic relevance.
Eighty samples of PC tissue, 32 samples of normal pancreatic tissue, and 20 samples of chronic pancreatitis (cP) tissue were immunostained with monoclonal anti-CD31 and polyclonal anti-VEGF antibody. The MVD was correlated with clinicopathological features and survival.
Microvessel density was higher in PC than in cP (P < 0.001). Residual tumor status was highly predictive for survival (P < 0.001). After stratification for residual tumor status, we identified lymph node metastasis (LNM) in more than two lymph nodes (P < 0.04) and high MVD (P < 0.03) as risk factors for mortality. Multivariate analysis revealed only a high MVD (P = 0.03, odds ratio 0.441, 95% confidence interval 0.211-0.821) as an independent predictor of poor survival. Vascular endothelial growth factor was found over stromal cells in cP and over ductal adenocarcinoma cells in PC. Vascular endothelial growth factor expression status was not predictive of survival (P < 0.07).
This study confirms the role of angiogenesis in PC and identifies MVD as an independent prognostic factor in patients with curatively resected PC.
血管生成及其最显著的血管内皮生长因子（VEGF）在胰腺疾病中的作用仍存在争议。我们比较了正常胰腺、慢性胰腺炎和胰腺癌（PC）组织中的微血管密度（MVD）和 VEGF 状态，以确定其预后相关性。
免疫组化染色用抗 CD31 单克隆抗体和抗 VEGF 多克隆抗体对 80 例 PC 组织、32 例正常胰腺组织和 20 例慢性胰腺炎（cP）组织进行染色。MVD 与临床病理特征和生存相关。
PC 组织中的 MVD 高于 cP（P<0.001）。残留肿瘤状态对生存有高度预测性（P<0.001）。在按残留肿瘤状态分层后，我们发现淋巴结转移（LNM）超过两个淋巴结（P<0.04）和高 MVD（P<0.03）是死亡率的危险因素。多变量分析显示，只有高 MVD（P=0.03，优势比 0.441，95%置信区间 0.211-0.821）是预后不良的独立预测因素。VEGF 存在于 cP 的间质细胞中，也存在于 PC 的导管腺癌细胞中。VEGF 表达状态与生存无关（P<0.07）。
本研究证实了血管生成在 PC 中的作用，并确定了 MVD 是可切除 PC 患者的独立预后因素。
