子宫内膜癌中的血管生成

Angiogenesis in endometrial carcinoma.

作者信息

Kaku T, Kamura T, Kinukawa N, Kobayashi H, Sakai K, Tsuruchi N, Saito T, Kawauchi S, Tsuneyoshi M, Nakano H

机构信息

Department of Gynecology and Obstetrics, Faculty of Medicine, Kyushu University, Higashi-ku, Fukuoka, Japan.

出版信息

Cancer. 1997 Aug 15;80(4):741-7. doi: 10.1002/(sici)1097-0142(19970815)80:4<741::aid-cncr13>3.0.co;2-t.

DOI:10.1002/(sici)1097-0142(19970815)80:4<741::aid-cncr13>3.0.co;2-t

PMID:9264358

Abstract

BACKGROUND

Tumor angiogenesis is essential for tumor growth and metastases. Recently, microvessel density (MVD), a measure of tumor angiogenesis, has been found to have prognostic significance for predicting metastasis and survival in many tumor types. This study was conducted to determine how MVD was related to several clinicopathologic parameters and correlated with metastasis and survival in patients with endometrial carcinoma.

METHODS

From 1979 through 1989, 85 cases of clinical Stage I and II endometrial carcinomas treated initially by hysterectomy with pelvic lymph node dissection were reviewed histologically. All hysterectomy specimens were stained immunohistologically for factor VIII-related antigen. MVD was counted in a x200 field (x20 objective lens and x10 ocular lens, 0.785 mm2 per field) in the most active area of neovascularization. Results were expressed as the highest number of microvessels identified within any single x200 field. Statistical analysis included the Mann-Whitney U test, Kruskal-Wallis test of variance, and the Spearman rank correlation test. Survival was calculated using the Kaplan-Meier method and differences in survival were analyzed using the log rank test. MVD and several other prognostic parameters were examined for their correlation with progression free survival (PFS) and overall survival (OS) by a multivariate analysis according to the Cox proportional hazards model.

RESULTS

MVD was significantly correlated with tumor grade (P = 0.0281), myometrial invasion (P = 0.0282), and lymph-vascular space invasion (P = 0.0073). There was no correlation between microvessel count and lymph node status and stage. Patients with a high MVD (> or =60) had significantly worse PFS and OS than those with a low MVD (<60) (log rank test, P = 0.0116 and P = 0.0096, respectively). Multivariate analysis showed that MVD correlated significantly and independently with PFS and OS.

CONCLUSIONS

In this study, MVD was found to be an independent prognostic factor for PFS and OS in patients with endometrial carcinoma.

摘要

背景

肿瘤血管生成对于肿瘤的生长和转移至关重要。最近，微血管密度（MVD）作为肿瘤血管生成的一种衡量指标，已被发现对预测多种肿瘤类型的转移和生存具有预后意义。本研究旨在确定MVD与子宫内膜癌患者的几个临床病理参数之间的关系，以及与转移和生存的相关性。

方法

回顾性分析1979年至1989年间最初接受子宫切除术加盆腔淋巴结清扫术治疗的85例临床I期和II期子宫内膜癌病例的组织学资料。所有子宫切除标本均进行免疫组织化学染色检测VIII因子相关抗原。在新生血管形成最活跃的区域，于x200视野（x20物镜和x10目镜，每视野0.785平方毫米）内计数MVD。结果以任何单个x200视野内识别出的微血管最高数量表示。统计分析包括Mann-Whitney U检验、Kruskal-Wallis方差检验和Spearman秩相关检验。采用Kaplan-Meier法计算生存率，并使用对数秩检验分析生存差异。根据Cox比例风险模型，通过多变量分析检查MVD和其他几个预后参数与无进展生存期（PFS）和总生存期（OS）的相关性。

结果

MVD与肿瘤分级（P = ０.０２８１）、肌层浸润（P = ０.０２８２）和淋巴管间隙浸润（P = ０.００７３）显著相关。微血管计数与淋巴结状态和分期之间无相关性。MVD高（≥60）的患者的PFS和OS明显比MVD低（<60）的患者差（对数秩检验，分别为P = ０.０１１６和P = ０.００９６）。多变量分析显示，MVD与PFS和OS显著且独立相关。