Department of Internal Medicine, Division of Endocrinology and Metabolism, Tokat State Hospital, Tokat, Turkey.
Department of Internal Medicine, Division of Endocrinology and Metabolism, Muş State Hospital, Muş, Turkey.
Endocrine. 2023 Dec;82(3):638-645. doi: 10.1007/s12020-023-03489-2. Epub 2023 Aug 18.
Endocan and vascular endothelial growth factor (VEGF) are markers expressed in various cancer types that are highly vascular, and they have prognostic significance for these cancers. In this study, we aimed to show the expression of endocan and VEGF in pheochromocytoma tumor tissues and to evaluate their correlations with histopathological parameters.
Thirty-eight patients who had been operated for pheochromocytoma were included in the study. As the control group, 28 subjects whose specimens contained normal adrenal medulla tissue were included. The formalin-fixed paraffin-embedded specimens of pheochromocytoma patients were evaluated for Pheochromocytoma of the Adrenal gland Scaled Score (PASS). Sections were then stained for immunohistochemical analysis. The degree of endocan and VEGF positivity was determined by the proportion of stained cells on a negative to strong scale.
Endocan (p < 0.001) and VEGF (p = 0.004) expressions were found to be significantly higher in the pheochromocytoma group than in the control group. In the pheochromocytoma group, total PASS score (r = 0.714; p < 0.001) and most of the PASS score components were positively correlated with the level of endocan expression. Median Ki-67 index (p = 0.010), total PASS score (p < 0.001), tumor cell spindling (p = 0.048), and nuclear pleomorphism (p = 0.030) were higher in pheochromocytoma with VEGF expression than in those without.
If our findings are supported by studies with a larger sample size, we think that endocan has the potential to be used both as a tumor marker and in predicting malignancy potential in patients with pheochromocytoma, and that the detection of VEGF expression in these tumors is also associated with an increase in malignancy potential.
内皮细胞蛋白 C 受体（Endocan）和血管内皮生长因子（VEGF）是在各种高血管生成的癌症类型中表达的标志物，它们对这些癌症具有预后意义。本研究旨在显示嗜铬细胞瘤肿瘤组织中 Endocan 和 VEGF 的表达，并评估它们与组织病理学参数的相关性。
纳入 38 名因嗜铬细胞瘤接受手术的患者作为研究对象。同时纳入 28 名肾上腺髓质组织标本中包含正常肾上腺髓质组织的患者作为对照组。对嗜铬细胞瘤患者的福尔马林固定石蜡包埋标本进行嗜铬细胞瘤的肾上腺评分（PASS）评估。然后对切片进行免疫组织化学分析。通过阴性到强染色细胞比例来确定 Endocan 和 VEGF 阳性的程度。
嗜铬细胞瘤组的 Endocan（p<0.001）和 VEGF（p=0.004）表达明显高于对照组。在嗜铬细胞瘤组中，总 PASS 评分（r=0.714；p<0.001）和大多数 PASS 评分成分与 Endocan 表达水平呈正相关。Ki-67 指数中位数（p=0.010）、总 PASS 评分（p<0.001）、肿瘤细胞梭形（p=0.048）和核异型性（p=0.030）在有 VEGF 表达的嗜铬细胞瘤中高于无 VEGF 表达的嗜铬细胞瘤。
如果我们的研究结果得到更大样本量研究的支持，我们认为 Endocan 有可能既作为肿瘤标志物，又能预测嗜铬细胞瘤患者的恶性潜能，而这些肿瘤中 VEGF 表达的检测也与恶性潜能的增加有关。
