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目的探讨胃癌血管形成和肿瘤细胞增殖能力的相关性及这两项指标与临床病理特征和预后之间的关系。方法用免疫组织化学ＡＢＣ法，采用抗Ⅷ因子相关抗原的（ａｎｔｉＦⅧＲＡｇ）单克隆抗体进行微血管内皮细胞染色，用ＰＣＮＡ单克隆抗体（ＰＣ１０）进行肿瘤细胞增殖核抗原的染色。分别计数１１６例胃癌中的微血管密度（ＭＶＤ）和ＰＣＮＡ指数，分析它们与临床病理因素及预后的关系。结果ＭＶＤ与胃癌的淋巴结转移（Ｐ＜０．０１）、腹腔内转移（Ｐ＜０．０１）有关，且随ＴＮＭ分期而增加（Ｐ＜０．０１）；ＰＣＮＡ指数与浆膜浸润（Ｐ＜０．０５）、淋巴结转移（Ｐ＜０．０１）、腹腔内转移（Ｐ＜０．０５）有关，Ⅳ期肿瘤中ＰＣＮＡ指数明显高于Ⅰ期肿瘤（Ｐ＜０．０１）。ＭＶＤ与ＰＣＮＡ指数呈正相关（ｒ＝０．３５，Ｐ＜０．０１）。低ＭＶＤ组（ＭＶＤ＜２３）和低ＰＣＮＡ组（ＰＣＮＡ＜４８）的５年总体生存率均分别明显高于高ＭＶＤ组（ＭＶＤ≥２３）和高ＰＣＮＡ组（ＰＣＮＡ≥４８）的５年总体生存率（均Ｐ＜０．０１）。多因素分析表明，ＭＶＤ和ＰＣＮＡ指数均是独立的预后因素。结论胃癌组织中的ＭＶＤ和ＰＣＮＡ指数能反映胃癌的恶性程度，是判断预后和指导辅助治疗的有效指标。
Objective To investigate the correlation between angiogenesis and tumor cell proliferation in gastric cancer, and the relationship between these two indexes and clinicopathological features and prognosis. Methods Microvascular endothelial cells were stained with anti-VIII factor-related antigen (antiF-VIIIRAg) monoclonal antibody by immunohistochemistry ABC method. PCNA monoclonal antibody (PC10) was used to stain tumor cell proliferation antigen. The microvessel density (MVD) and PCNA index in 116 cases of gastric cancer were counted, respectively, and their relationship with clinicopathological factors and prognosis was analyzed. Results MVD was associated with lymph node metastasis (P<0.01) and intra-abdominal metastasis (P<0.01) in gastric cancer and increased with TNM stage (P<0.01); PCNA index and serosal infiltration (P< 0.05), lymph node metastasis (P <0.01), intra-abdominal metastasis (P <0.05), PCNA index of stage IV tumor was significantly higher than that of stage I tumor (P <0.01). There was a positive correlation between MVD and PCNA index (r=0.35, P<0.01). The 5-year overall survival rates in the low MVD group (MVD<23) and low PCNA group (PCNA<48) were significantly higher than those of the 5-year overall survival in the high MVD group (MVD ≥23) and high PCNA group (PCNA ≥48), respectively. Rates (all P < 0.01). Multivariate analysis showed that both MVD and PCNA index were independent prognostic factors. Conclusion MVD and PCNA index in gastric cancer tissues can reflect the degree of malignancy of gastric cancer. It is an effective index to judge prognosis and guide adjuvant treatment.