Delahunt B, Bethwaite P B, Thornton A
Department of Pathology, Wellington School of Medicine, University of Otago, New Zealand.
Br J Urol. 1997 Sep;80(3):401-4. doi: 10.1046/j.1464-410x.1997.00374.x.
To investigate the association between tumour vascularity and patient survival in a series of clear-cell renal cell carcinoma (RCC), which often metastasizes via the vascular route and frequently has a prominent vascular network.
Vessels were labelled in sections from 150 cases of clear cell RCC by factor VIII immunohistochemistry. The mean microvessel density (MMD), expressed as the number of vessels per 10 high-power fields (HPFs, x400, aggregate field area 1.452 mm2) and tumour microvessel area (TMA), expressed as the percentage of the total tumour area within 10 HPFs, were measured for each case. The relationship between MMD and TMA, tumour stage and grade, and patient survival over a 5-year follow-up was determined.
Tumour MMD ranged from 1 to 238 vessels per HPF, while the TMA was 1.2-60.8%. There was a weak but significant difference for MMD between tumour grades (P < 0.01) and stages (P < 0.05). There was no significant association between TMA and either tumour stage or grade. Division of cases according to MMD < or = 40 and > 40 per HPF showed a significant difference in survival curves between both groups, with a higher MMD being associated with longer patient survival. The significant association between MMD and survival was retained for stage 3 tumours only when cases were stratified according to Robson's stage at presentation. TMA did not correlate with survival.
The assessment of tumour vascularity is of prognostic significance for clear cell RCC. The significant inverse relationship between MMD and patient survival suggests that for tumours with a poor prognosis, decreased MMD is associated with tumour fibrosis and the development of large diameter vascular channels.
在一系列透明细胞肾细胞癌（RCC）中研究肿瘤血管生成与患者生存率之间的关联，该肿瘤常通过血管途径转移且通常具有显著的血管网络。
采用因子VIII免疫组化法对150例透明细胞RCC切片中的血管进行标记。测量每例患者的平均微血管密度（MMD），以每10个高倍视野（HPF，×400，总视野面积1.452平方毫米）中的血管数量表示，以及肿瘤微血管面积（TMA），以10个HPF内肿瘤总面积的百分比表示。确定MMD与TMA、肿瘤分期和分级以及5年随访期内患者生存率之间的关系。
肿瘤MMD范围为每HPF 1至238条血管，而TMA为1.2% - 60.8%。肿瘤分级（P < 0.01）和分期（P < 0.05）之间的MMD存在微弱但显著的差异。TMA与肿瘤分期或分级之间均无显著关联。根据每HPF中MMD≤40和>40对病例进行分组，两组生存曲线存在显著差异，较高的MMD与患者较长的生存期相关。仅当根据就诊时的罗布森分期对病例进行分层时，MMD与3期肿瘤的生存率之间的显著关联才得以保留。TMA与生存率无关。
肿瘤血管生成的评估对透明细胞RCC具有预后意义。MMD与患者生存率之间的显著负相关表明，对于预后不良的肿瘤，MMD降低与肿瘤纤维化及大直径血管通道的形成有关。
