Shi Linna, Lv Ruihua, Li Chen, Han Dong, Ren Zhanli, Ren Ge
College of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, China.
Oncology Third Department, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China.
Transl Androl Urol. 2020 Aug;9(4):1670-1677. doi: 10.21037/tau-20-970.
Renal cell carcinoma (RCC) is a common malignant tumor of the urinary system. This study aimed to analyze the expression of vascular endothelial growth factor C (VEGF-C) in RCC and its relationship with pathological parameters and prognosis.
The clinical data of 68 patients who underwent surgical treatment and confirmed to be RCC by pathology from February 2012 to January 2014 were collected. The specimens of carcinoma tissues of the 68 patients were collected, among which 20 patients were collected from normal tissue specimens adjacent to the cancer more than 5 cm away from the tumor as controls. The VEGF-C expression level was detected by immunohistochemistry, and the relationship between VEGF-C expression and clinical pathological parameters and prognosis of RCC was analyzed.
The positive expression rate of VEGF-C in cancer tissues of RCC patients was significantly higher than the adjacent tissues (85.29% 15.00%) (P<0.05). The positive expression rate of VEGF-C in cancer tissues of RCC patients with low-to- moderate differentiation, stage III-IV, and lymph node metastasis was higher than that of RCC patients with high differentiation, stage I-II, and no lymph node metastasis (P<0.05). The survival rates of RCC patients at 1-, 3- and 5-year follow-up were 82.35% (56/68), 54.41% (37/68), and 32.35% (22/68), and the survival time of patients with positive VEGF-C expression was shorter than patients with negative expression (P<0.05). There was no significant difference in the 5-year survival rate among RCC patients according to sex or presence of muscular infiltration (P>0.05). Meanwhile, the 5-year survival rate was higher in patients with tumor diameter <5 cm, high differentiation, stage I-II, no lymph node metastasis, VEGF-C-negative expression, and aged <55 years old (P<0.05). The Cox regression model analysis showed that differentiation degree, clinical stage, lymph node metastasis, and VEGF-C expression were all independent risk factors affecting the prognosis of RCC patients (P<0.05).
VEGF-C is highly expressed in cancer tissues of RCC patients, and is related to clinical stage, pathological differentiation, and lymph node metastasis, which maybe an effective factor of prognosis prediction.
肾细胞癌（RCC）是泌尿系统常见的恶性肿瘤。本研究旨在分析血管内皮生长因子C（VEGF-C）在RCC中的表达及其与病理参数和预后的关系。
收集2012年2月至2014年1月期间68例行手术治疗且经病理确诊为RCC患者的临床资料。收集这68例患者的癌组织标本，其中20例取自距肿瘤边缘5 cm以外的癌旁正常组织标本作为对照。采用免疫组织化学法检测VEGF-C表达水平，并分析VEGF-C表达与RCC临床病理参数及预后的关系。
RCC患者癌组织中VEGF-C阳性表达率显著高于癌旁组织（85.29%比15.00%）（P<0.05）。低至中分化、Ⅲ-Ⅳ期及有淋巴结转移的RCC患者癌组织中VEGF-C阳性表达率高于高分化、Ⅰ-Ⅱ期及无淋巴结转移的RCC患者（P<0.05）。RCC患者1年、3年和5年随访生存率分别为82.35%（56/68）、54.41%（37/68）和32.35%（22/68），VEGF-C表达阳性患者的生存时间短于阴性表达患者（P<0.05）。RCC患者5年生存率在性别或有无肌层浸润方面差异无统计学意义（P>0.05）。同时，肿瘤直径<5 cm、高分化、Ⅰ-Ⅱ期、无淋巴结转移、VEGF-C阴性表达及年龄<55岁的患者5年生存率较高（P<0.05）。Cox回归模型分析显示，分化程度、临床分期、淋巴结转移及VEGF-C表达均为影响RCC患者预后的独立危险因素（P<0.05）。
VEGF-C在RCC患者癌组织中高表达，与临床分期、病理分化及淋巴结转移有关，可能是预后预测的有效因素。
