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目的:观察结直肠癌组织血管内皮生长因子-C(vascular endothelial growth factor-C,VEGF-C)和Podoplanin的表达,探讨VEGF-C和Podoplanin与结直肠肿瘤淋巴管生成、发生、发展及预后的关系。方法:收集2011-03-15-2012-03-15兰州军区兰州总医院肛肠外科手术切除的结直肠癌组织新鲜标本40例,同时收集距相应肿瘤组织边缘5～10cm的正常结直肠组织(以下简称正常组织)标本40例作为正常对照;应用免疫组织化学SP法检测40例结直肠癌组织及40正常结直肠组织VEGF-C和Podoplanin的表达,并采用t检验、单因素方差分析和χ2检验对两指标表达与临床病理因素之间相关性进行分析。结果:结直肠癌组织和正常组织VEGF-C阳性率分别为55%和15%,P=0.009。结直肠癌组织和正常组织VEGF-C Podoplanin阳性淋巴管密度(lymphatic vessel density,LVD)分别为6.03±3.72和3.33±2.76,P=0.001。结直肠癌组织中淋巴结转移组和无淋巴结转移组VEGF-C阳性率分别为94%和29%,P=0.034;且与pTNM分期和Dukes分期密切相关。结直肠癌组织淋巴结转移组和无淋巴结转移组中LVD值分别为8.11±3.46和4.82±3.31,P=0.004;且与pTNM分期和Dukes分期密切相关。结直肠癌组织VEGF-C阳性和阴性表达LVD值分别为7.73±3.34和3.78±3.40,差异有统计学意义,P=0.001。结论:结直肠癌中VEGF-C阳性率和Podoplanin阳性LVD显著增高,且与淋巴结转移、肿瘤病理分期密切相关,提示VEGF-C可能通过诱导结直肠癌淋巴管生成,从而促进肿瘤细胞的淋巴转移;证实VEGF-C和Podoplanin在结直肠肿瘤淋巴管生成、发生、发展及肿瘤转移中起重要作用,并可能成为肿瘤预后判断的参考指标。
OBJECTIVE: To observe the expression of vascular endothelial growth factor-C (VEGF-C) and Podoplanin in colorectal cancer and to explore the relationship between VEGF-C, Podoplanin and colorectal neoplasms lymphangiogenesis, occurrence, development and prognosis relationship. METHODS: Forty fresh specimens of colorectal carcinoma resected by anorectal surgery in Lanzhou General Hospital of Lanzhou Military Region were collected from March 15, 2011 to March 15, 2010 while collecting normal colorectal tissues (5 ~ 10 cm away from the edge of corresponding tumor tissues 40 cases of colorectal cancer tissues and 40 normal colorectal tissues were detected by immunohistochemistry SP method and t-test, one-way ANOVA and χ2 test were used to detect the expression of VEGF-C and Podoplanin The correlation between the expression of two indicators and clinicopathological factors were analyzed. Results: The positive rates of VEGF-C in colorectal cancer tissues and normal tissues were 55% and 15%, respectively, P = 0.009. The positive lymphatic vessel density (LVD) of VEGF-C Podoplanin in colorectal cancer tissues and normal tissues were 6.03 ± 3.72 and 3.33 ± 2.76, respectively, P = 0.001. The positive rates of VEGF-C in colorectal cancer tissues were 94% and 29%, respectively, P = 0.034, which were closely related to pTNM staging and Dukes staging. The LVD values of colorectal cancer with lymph node metastasis and non-lymph node metastasis were 8.11 ± 3.46 and 4.82 ± 3.31, respectively, P = 0.004, which were closely related to pTNM staging and Dukes staging. The positive and negative expressions of VEGF-C in colorectal cancer tissues were 7.73 ± 3.34 and 3.78 ± 3.40, respectively, with significant difference (P = 0.001). Conclusion: The positive rates of VEGF-C and Podoplanin-positive LVD in colorectal cancer are significantly higher than those in normal colorectal cancer tissues, which are closely related to lymph node metastasis and tumor pathological stage, suggesting that VEGF-C may promote lymphatic metastasis of colorectal cancer by inducing lymphangiogenesis ; Confirmed VEGF-C and Podoplanin in colorectal tumor lymphangiogenesis, occurrence, development and tumor metastasis play an important role, and may become a reference for the prognosis of tumor prognosis.