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目的研究血管内皮生长因子-A(VEGF-A),血管内皮生长因子-C(VEGF-C)和胎盘生长因子(PIGF)的表达量与肝癌临床病理的关系,并评估PIGF表达量对肝癌切除后复发的影响。方法随机收集2006年5月—2008年8月行肝癌切除患者的肿瘤标本63例。采用实时定量PCR的方法检测肝癌组织VEGF-A,VEGF-C和PIGF的表达量;采用ELISA检测各个标本PIGF蛋白的浓度。以CD34免疫组化染色评估肝癌组织的微血管密度。分析上述3个血管生成因子与肝癌临床病理的关系,以及与肝癌切除术后早期复发的关系。并观察PIGF含量与肝癌微血管密度的关系。结果 VEGF-A,VEGF-C和PIGF在肝癌早期转移病例中的高表达率分别为62.5%(10/16),68.8%(11/16)和87.5%(14/16),PIGF基因在早期转移病例中的高表达率高于前两者(P<0.05);VEGF-C和PIGF表达量与AFP浓度相关,AFP浓度>245 ng/dL时,VEGF-C和PIGF的高表达率明显增加(P<0.05);肝癌处于II期或III期时,PIGF蛋白含量越高,早期复发的可能性越大,有统计学差异(P<0.05)。肝癌II+III期患者的微血管密度明显高于I期患者的微血管密度(P<0.05),肿瘤直径大于5 cm患者的微血管密度与PIGF表达量呈正相关(r=0.58,P=0.025)。结论 PIGF在肝癌组织中的表达量与肝癌切除后复发有关,尤其在肝癌的II,III期存在相关性。PIGF可以作为晚期肝癌复发的独立预测因子。
Objective To investigate the relationship between the expression of vascular endothelial growth factor-A (VEGF-A), vascular endothelial growth factor-C (VEGF-C) and placental growth factor (PIGF) and clinicopathological features of hepatocellular carcinoma After the recurrence of the impact. Methods Totally 63 patients with liver cancer resected from May 2006 to August 2008 were collected. The expression of VEGF-A, VEGF-C and PIGF in hepatocellular carcinoma was detected by real-time quantitative PCR. The concentration of PIGF protein in each specimen was detected by ELISA. The microvessel density of hepatocellular carcinoma was evaluated by CD34 immunohistochemical staining. To analyze the relationship between the above three angiogenic factors and the clinicopathological features of hepatocellular carcinoma and the relationship with the early recurrence after resection of hepatocellular carcinoma. And observe the relationship between PIGF content and microvessel density of liver cancer. Results The high expression rates of VEGF-A, VEGF-C and PIGF in early stage of HCC were 62.5% (10/16), 68.8% (11/16) and 87.5% (14/16), respectively. The high expression rate of VEGF-C and PIGF was correlated with the level of AFP in metastatic cases (P <0.05). The high expression rates of VEGF-C and PIGF in AFP> 245 ng / dL (P <0.05). The higher the PIGF protein content was, the higher the possibility of early recurrence was when the HCC was stage II or III (P <0.05). The microvessel density in patients with stage II + III hepatocellular carcinoma was significantly higher than that in stage I patients (P <0.05). The microvessel density was positively correlated with the PIGF expression in patients with tumors larger than 5 cm (r = 0.58, P = 0.025). Conclusion The expression of PIGF in hepatocellular carcinoma is related to recurrence after resection of hepatocellular carcinoma, especially in stages II and III of hepatocellular carcinoma. PIGF can be used as an independent predictor of advanced liver cancer recurrence.