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目的 研究小儿原发性肝脏恶性肿瘤中血管内皮生长因子 (VEGF)和微血管密度(MVD)的特点。方法 采用SPTM免疫组化方法检查 14例小儿原发性肝脏恶性肿瘤VEGF阳性表达以及MVD计数。病理分类 :肝细胞癌 7例 ,肝母细胞瘤 5例 ,恶性间叶瘤和横纹肌肉瘤各 1例。另选 12例成年人肝癌手术切除标本作为对照。结果 小儿肝肿瘤组VEGF阳性表达面积显著高于成人肝癌组 (P <0 .0 5 ) ;尤其小儿肝癌组与成人组对比差异有极显著性意义 (P <0 .0 1)。小儿肝肿瘤组的MVD也显著高于成人肝癌 (P <0 .0 5 )。小儿肝癌组患儿均在 2年内死亡 ;非肝癌肝脏肿瘤预后较好 ,2例存活超过 5年。结论 小儿肝脏恶性肿瘤存在有高度血管再生性的特点 ,肿瘤的生长快 ,预后差 ,以小儿肝癌最为突出。长期存活患儿的VEGF表达均为阴性。
Objective To study the characteristics of vascular endothelial growth factor (VEGF) and microvessel density (MVD) in children with primary hepatic malignancies. Methods SP immunohistochemical method was used to examine the VEGF positive expression and MVD count in 14 cases of primary liver cancer in children. Pathological classification: Hepatocellular carcinoma in 7 cases, hepatoblastoma in 5 cases, malignant mesenchymal tumor and rhabdomyosarcoma in 1 case. Another 12 cases of adult liver cancer resection specimens as a control. Results The positive expression area of VEGF in pediatric liver tumor group was significantly higher than that in adult hepatocellular carcinoma group (P <0.05). Especially in pediatric hepatocellular carcinoma group and adult group, the difference was significant (P <0.01). MVD in pediatric liver tumor group was also significantly higher than that in adult liver cancer (P <0.05). Pediatric liver cancer patients died within 2 years; non-liver cancer liver cancer prognosis is better, 2 cases survived more than 5 years. Conclusion There is a high degree of vascular regeneration of malignant liver tumors in children, the tumor grows fast, the prognosis is poor, the most prominent in children with hepatocellular carcinoma. Long-term survival of children with VEGF expression were negative.