子宫颈腺癌中的血管生成。

Angiogenesis in adenocarcinoma of the uterine cervix.

作者信息

Kaku T, Hirakawa T, Kamura T, Amada S, Kinukawa N, Kobayashi H, Sakai K, Ariyoshi K, Sonoda K, Nakano H

机构信息

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

出版信息

Cancer. 1998 Oct 1;83(7):1384-90. doi: 10.1002/(sici)1097-0142(19981001)83:7<1384::aid-cncr16>3.0.co;2-0.

DOI:10.1002/(sici)1097-0142(19981001)83:7<1384::aid-cncr16>3.0.co;2-0

PMID:9762940

Abstract

BACKGROUND

Angiogenesis is essential for tumor growth, progression, and metastases. Microvessel density (MVD), a measure of tumor angiogenesis, has been found to have prognostic significance in many tumor types for predicting metastasis and survival.

METHODS

Between 1979-1989, 56 cases of FIGO Clinical Stage I and II adenocarcinoma of the uterine cervix treated by hysterectomy were reviewed histologically. All hysterectomy specimens were stained immunohistologically for factor VIII-related antigen. MVD was counted in a x200 field (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. MVD and several other prognostic parameters were examined for correlation with progression free survival (PFS) and overall survival (OS) by a multivariate analysis according to the Cox proportional hazards model.

RESULTS

In early adenocarcinoma of the uterine cervix, MVD was increased significantly in invasive areas compared with adjacent nonneoplastic areas (median: 62.5 [range, 30-105] vs. median: 36.5 [range, 23-47]; P=0.0003). MVD also was significantly correlated with ascites cytology (P=0.0377). There was no correlation between microvessel count and lymph node status, depth of invasion, disease stage, lymph-vascular space invasion, grade, or parametrial involvement. Patients with high MVD (> or=75) had significantly worse PFS and OS than those with low MVD (< 75) (log rank test, P=0.0180 and 0.0199, respectively). Multivariate analysis showed that MVD correlated significantly and independently with PFS and OS.

CONCLUSIONS

In adenocarcinoma of the cervix, MVD is an independent prognostic factor for PFS and OS.

摘要

背景

血管生成对于肿瘤的生长、进展和转移至关重要。微血管密度（MVD）作为肿瘤血管生成的一项指标，已发现在许多肿瘤类型中对预测转移和生存具有预后意义。

方法

回顾性分析1979年至1989年间接受子宫切除术治疗的56例国际妇产科联盟（FIGO）临床分期为I期和II期的子宫颈腺癌患者的组织学资料。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（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。根据Cox比例风险模型，通过多因素分析检测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

在子宫颈早期腺癌中，与相邻的非肿瘤区域相比，浸润区域的MVD显著增加（中位数：62.5[范围，30 - 105]对中位数：36.5[范围，23 - 47]；P = 0.0003）。MVD也与腹水细胞学显著相关（P = 0.0377）。微血管计数与淋巴结状态、浸润深度、疾病分期、淋巴血管间隙浸润、分级或宫旁受累之间无相关性。MVD高（≥75）的患者的PFS和OS显著差于MVD低（<75）的患者（对数秩检验，P分别为0.0180和0.0199）。多因素分析显示，MVD与PFS和OS显著且独立相关。