Fang Luo, He Ying, Liu Yujia, Ding Haiying, Tong Yinghui, Hu Luying, Wang Canming, Zhang Yiwen, Zheng Xiaowei, Huang Ping
Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Department of Pharmacy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China.
J Cancer. 2019 Jun 9;10(15):3397-3406. doi: 10.7150/jca.31231. eCollection 2019.
: Sustained tumor growth and metastasis require sufficient blood supply, and microvessel area (MVA) has been reported that is related to prognosis of cancer patients. However, tumor cells may not be nourished enough by blood vessels when the cells are separated from vessels by thick stroma. Therefore we investigated whether stroma-area normalized MVA (SnMVA) is a more important prognostic factor than MVA. : 100 NSCLC patients who underwent resection between July 2011 and October 2012 were randomly selected. We determined the MVA of the tumor tissues by anti-CD31 immunostaining of microvessels. Stroma-area normalized MVA (SnMVA) was a ratio of MVA to stromal area. Correlation of MVA and SnMVA with overall survival (OS) or progression-free survival (PFS) was assessed using multivariate analysis. : Median MVA was 0.0228 (range, 0.00393 to 0.172), and median SnMVA was 0.0441 × 10 (range, 0.00393 × 10 to 0.259 × 10). There was no significant difference in OS between groups of different MVA (HR 0.58, 95%CI 0.28 to 1.19, = 0.148). In contrast, the risk of death was significantly decreased in high SnMVA group (at or below the median) than in group with low SnMVA (HR 0.47, 95%CI 0.23 to 0.97, = 0.046). Furthermore, in multivariate analysis, high SnMVA, but not MVA, was an independent prognostic factor after adjusting for age, sex, tumor stage and other factors. OS was significantly associated with SnMVA in six of seven subgroup analysis, but with MVA in only three. : Our study showed that the NSCLC patients with high SnMVA had higher OS. And SnMVA is a prognostic factor with greater accuracy than MVA. Since stroma exists widely in a variety of cancer tissues, we infer that SnMVA may also predict the prognostic of other types of cancers.
持续的肿瘤生长和转移需要充足的血液供应，据报道微血管面积（MVA）与癌症患者的预后相关。然而，当肿瘤细胞被厚厚的基质与血管分隔开时，血管可能无法为肿瘤细胞提供足够的营养。因此，我们研究了基质面积标准化的MVA（SnMVA）是否比MVA是更重要的预后因素。2011年7月至2012年10月间接受手术切除的100例非小细胞肺癌（NSCLC）患者被随机选取。我们通过微血管的抗CD31免疫染色来测定肿瘤组织的MVA。基质面积标准化的MVA（SnMVA）是MVA与基质面积的比值。使用多因素分析评估MVA和SnMVA与总生存期（OS）或无进展生存期（PFS）的相关性。MVA中位数为0.0228（范围0.00393至0.172），SnMVA中位数为0.0441×10（范围0.00393×10至0.259×10）。不同MVA组之间的OS无显著差异（风险比0.58，95%可信区间0.28至1.19，P = 0.148）。相比之下，高SnMVA组（中位数及以下）的死亡风险比低SnMVA组显著降低（风险比0.47，95%可信区间0.23至0.97，P = 0.046）。此外，在多因素分析中，调整年龄、性别、肿瘤分期和其他因素后，高SnMVA而非MVA是独立的预后因素。在七项亚组分析中的六项中，OS与SnMVA显著相关，但仅三项与MVA相关。我们的研究表明，高SnMVA的NSCLC患者有更高的OS。并且SnMVA是比MVA更准确的预后因素。由于基质广泛存在于各种癌症组织中，我们推断SnMVA也可能预测其他类型癌症的预后。
