Martinović Željko, Kovač Dražen, Martinović Cvita
Department of Surgery, Croatian Hospital "Dr. Fra Mato Nikolić", 72 276, Nova Bila, Bosnia and Herzegovina.
Department of Pathology, School of Medicine, University of Rijeka, 51 000, Rijeka, Croatia.
World J Surg Oncol. 2016 Apr 22;14:122. doi: 10.1186/s12957-016-0877-6.
Angiogenesis plays a pivotal role in malignant tumor progression. The count of blood microvessels of the tumor has been recognized as an indicator of malignant potential of the tumors and provides the ability to predict tumors recurrence. The role endoglin in the Dukes B rectal cancer is still unexplored. The aims of this study were to examine immunohistochemical expression of endoglin in resected rectal cancer and investigate the relationship of tumor recurrence and other clinicopathological variables to the endoglin-assessed microvessel density of the tumor tissue and distal resection margins.
The study included 95 primary rectal adenocarcinomas, corresponding to 95 distal and 95 proximal resection margin specimens from surgical resection samples. Tumor specimens were paraffin embedded, and immunohistochemical staining for the CD105 endothelial antigen was performed to count CD105-MVD. For exact measurement of the CD105-MVD used, a computer-integrated system Alphelys Spot Browser 2 was used.
The MVD was significantly higher in the tumor samples compared with the distal resection margins (p < 0.0001) and the proximal resection margins (p < 0.0001). There was no significant difference in the MVD between distal and proximal resection margins (p = 0.147). The type of surgical resection was a significant factor for determining the recurrence of tumors (p = 0.0104). There was no significant effect of patients' age, gender, tumor location, grade of differentiation, histological tumor type, and the size and depth of tumor invasion on the recurrence of the tumor. The recurrence rate was significantly higher in the low CD105-MVD group of patients than in the high CD105-MVD group of patients (log rank test, p = 0.0406). Result of the multivariate analysis showed that the type of surgery (p = 0.0086), MVD tumors (p = 0.0385), and MVD of proximal resection margin (p = 0.0218) were the independent prognostic factors for the recurrent tumors.
CD105-assessed MVD could help to identify patients with more aggressive disease and increased risk of developing tumor recurrence after surgical treatment in stage II rectal cancer (RC).
血管生成在恶性肿瘤进展中起关键作用。肿瘤微血管计数已被视为肿瘤恶性潜能的指标，并具有预测肿瘤复发的能力。内皮糖蛋白在 Dukes B 期直肠癌中的作用仍未得到探索。本研究的目的是检测切除的直肠癌中内皮糖蛋白的免疫组化表达，并研究肿瘤复发及其他临床病理变量与肿瘤组织和远侧切缘内皮糖蛋白评估的微血管密度之间的关系。
本研究纳入 95 例原发性直肠腺癌，对应手术切除样本中的 95 个远侧切缘标本和 95 个近侧切缘标本。肿瘤标本经石蜡包埋，进行 CD105 内皮抗原的免疫组化染色以计数 CD105-MVD。为准确测量所使用的 CD105-MVD，采用计算机集成系统 Alphelys Spot Browser 2。
肿瘤样本中的 MVD 显著高于远侧切缘（p < 0.0001）和近侧切缘（p < 0.0001）。远侧切缘和近侧切缘之间的 MVD 无显著差异（p = 0.147）。手术切除类型是决定肿瘤复发的重要因素（p = 0.0104）。患者的年龄、性别、肿瘤位置、分化程度、组织学肿瘤类型以及肿瘤浸润的大小和深度对肿瘤复发无显著影响。低 CD105-MVD 组患者的复发率显著高于高 CD105-MVD 组患者（对数秩检验，p = 0.0406）。多因素分析结果显示，手术类型（p = 0.0086）、肿瘤 MVD（p = 0.0385）和近侧切缘 MVD（p = 0.0218）是复发肿瘤的独立预后因素。
CD105 评估的 MVD 有助于识别 II 期直肠癌（RC）手术治疗后疾病侵袭性更强且肿瘤复发风险增加的患者。
