Tong Yinghui, Yang Dihong, Mi Xiufang, Song Yu, Xin Wenxiu, Zhong Like, Shi Zheng, Xu Gaoqi, Ding Haiying, Fang Luo
The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China.
The Department of Pharmacy, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China.
Ann Transl Med. 2022 Jan;10(2):43. doi: 10.21037/atm-21-6566.
Despite the vital role of blood perfusion in tumor progression, the prognostic value of typical blood perfusion markers, such as microvessel density (MVD) or microvessel area (MVA), in patients with non-small cell lung cancer (NSCLC) is still unclear. This study established a modified MVD (mMVD) measurement based on perfusion distance and determined its prognostic value in patients with NSCLC.
A total of 100 patients with NSCLC were enrolled in this retrospective study. The intratumor microvessels of NSCLC patients were visualized using immunohistochemical staining for CD31. The blood perfusion distance was evaluated as the distance from each vessel to its nearest cancer cell (D), and the cutoff value for prognosis was determined. Apart from the total MVD (tMVD), microvessels near cancer cells within the cutoff-D were counted as mMVD. Predictive values for mortality and recurrence were evaluated and compared.
The D ranged from 1.6 to 269.8 µm (median, 13.1 µm). The mMVD (range: 2-70; median 23) was counted from tMVD according to the cutoff-D (~20 µm). Compared with tMVD, a larger fraction of mMVD (80% 2.9%) played a significant role in overall survival, with an improved area under the receiver operating characteristic (ROC) curve (AUC) (0.74 0.56). A high mMVD was an independent positive indicator of overall survival (OS) and progression-free survival (PFS). In contrast, tMVD was only related to PFS at the optimal cutoff.
Perfusion-distance-based mMVD is a promising prognostic factor for NSCLC patients with superior sensitivity, specificity, and clinical applicability compared to tMVD. This study provides novel insights into the prognostic role of tumor vessel perfusion in patients with NSCLC.
尽管血液灌注在肿瘤进展中起着至关重要的作用，但典型的血液灌注标志物，如微血管密度（MVD）或微血管面积（MVA），在非小细胞肺癌（NSCLC）患者中的预后价值仍不清楚。本研究基于灌注距离建立了一种改良的MVD（mMVD）测量方法，并确定了其在NSCLC患者中的预后价值。
本回顾性研究共纳入100例NSCLC患者。采用CD31免疫组化染色观察NSCLC患者肿瘤内微血管。将血液灌注距离评估为从每个血管到其最近癌细胞的距离（D），并确定预后的临界值。除了总MVD（tMVD）外，在临界D范围内靠近癌细胞的微血管被计为mMVD。评估并比较死亡率和复发的预测值。
D范围为1.6至269.8 µm（中位数，13.1 µm）。根据临界D（约20 µm）从tMVD中计算出mMVD（范围：2 - 70；中位数23）。与tMVD相比，更大比例的mMVD（80% 2.9%）在总生存中起显著作用，受试者工作特征（ROC）曲线下面积（AUC）有所改善（0.74 0.56）。高mMVD是总生存（OS）和无进展生存（PFS）的独立阳性指标。相比之下，tMVD仅在最佳临界值时与PFS相关。
与tMVD相比，基于灌注距离的mMVD是NSCLC患者有前景的预后因素，具有更高的敏感性、特异性和临床适用性。本研究为肿瘤血管灌注在NSCLC患者中的预后作用提供了新的见解。
