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目的通过检测信号转导和转录激活因子-3(STAT3)、血管内皮生长因子(VEGF)、微血管密度(MVD)在良、恶性嗜铬细胞瘤中的表达情况,探讨STAT3、VEGF能否成为一种预判恶性嗜铬细胞瘤的指标和肿瘤治疗的潜在靶点。方法选取1986年10月至2006年8月住院经手术治疗、且有完整的临床、病理和随访资料的嗜铬细胞瘤患者存档石蜡标本38例,其中良性嗜铬细胞瘤(良性组)21例,恶性嗜铬细胞瘤(恶性组)17例。恶性组首次手术确诊为嗜铬细胞瘤后随访4～155个月,良性组首次手术确诊为嗜铬细胞瘤后随访69～240个月;采用免疫组织化学技术,检测良性组、恶性组中STAT3、VEGF和MVD的表达情况。结果 STAT3在恶性组中的阳性表达率为70.6%,明显高于良性组中的阳性表达率(23.8%),两组间STAT3的表达具有显著的统计学差异(P<0.05)。VEGF在恶性组中的阳性表达率为82.4%,明显高于良性组中的阳性表达率(23.8%),且表达具有统计学意义(P<0.05)。MVD在恶性组中的阳性表达为36.41±13.00,良性组中为21.43±8.05,两者之间有显著性统计学意义(P<0.05)。在嗜铬细胞瘤中,STAT3与VEGF的表达以及VEGF与MVD的表达均呈正相关。结论 STAT3和VEGF有望成为预判嗜铬细胞瘤良、恶性的一种指标,并且有望成为肿瘤治疗的潜在靶点。
Objective To investigate the expression of STAT3, VEGF and MVD in benign and malignant pheochromocytomas by detecting signal transducers and activators of transcription-3 (STAT3), VEGF The prognosis of malignant pheochromocytoma indicators and potential targets for cancer treatment. Methods Thirty-eight paraffin-embedded specimens of pheochromocytoma were recruited from October 1986 to August 2006 with complete clinical, pathological and follow-up data. Among them, 21 cases of benign pheochromocytomas (benign group) , 17 cases of malignant pheochromocytoma (malignant group). The malignant group was followed up for 4 to 155 months after the first operation was diagnosed as pheochromocytoma. The positive group was followed up for 69 to 240 months after the first operative diagnosis of pheochromocytoma. Immunohistochemistry was used to detect STAT3 , VEGF and MVD expression. Results The positive expression rate of STAT3 in malignant group was 70.6%, which was significantly higher than that in benign group (23.8%). Stat3 expression was significantly different between two groups (P <0.05). The positive expression rate of VEGF in malignant group was 82.4%, which was significantly higher than that in benign group (23.8%), and the expression was statistically significant (P <0.05). The positive expression of MVD in malignant group was 36.41 ± 13.00, and in benign group was 21.43 ± 8.05, with significant statistical significance (P <0.05). In pheochromocytoma, STAT3 and VEGF expression and VEGF and MVD expression were positively correlated. Conclusion STAT3 and VEGF are expected to be a good predictor of benign and malignant pheochromocytomas and may be potential targets for tumor therapy.