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目的分析淋巴管新生与肾透明细胞癌患者预后的关系。方法用二步法免疫组织计数检测60例肾透明细胞癌患者标本中D2-40表达阳性的淋巴管,用光学显微镜测定癌周淋巴管密度,并观察是否出现癌内淋巴管,评价癌周淋巴管密度及癌内淋巴管与临床预后因素及患者生存率的关系。结果癌周淋巴管平均密度为16.89,按大于或小于平均值分为2组进行相关性分析表明,癌周淋巴管密度与远处转移、淋巴结转移、Fuhrman细胞核分级和肿瘤T分期无显著相关性(P>0.05)。癌内淋巴管的出现与远处转移、淋巴结转移及Fuhrman细胞核分级有显著相关性(P<0.05),与肿瘤T分期无相关性。生存分析显示,癌周淋巴管密度≥16.89组总体生存率为50.76%,癌周淋巴管密度<16.89组总体生存率为63.07%(P>0.05)。癌内淋巴管阳性组的总体生存率为30.86%,癌内淋巴管阴性组的总体生存率为64.36%(P<0.05)。结论癌周淋巴管密度对肾透明细胞癌患者的预后无影响,癌内淋巴管是肾透明细胞癌患者预后的不良因素。
Objective To analyze the relationship between lymphangiogenesis and the prognosis of patients with clear cell renal cell carcinoma. Methods Two-step immunohistochemistry was used to detect the expression of D2-40 positive lymphatic vessels in 60 cases of renal clear cell carcinoma. The lymphatic vessel density was measured by light microscopy and the presence of lymphatic vessels in the carcinoma was observed. Relationship between tube density, lymphatic vessel and clinical prognostic factors and survival rate of patients. Results The average density of lymphatic vessels around the cancer was 16.89, which was divided into two groups according to the above or below average value. Correlation analysis showed that there was no significant correlation between lymphatic vessel density and distant metastasis, lymph node metastasis, Fuhrman cell nuclear grade and tumor T stage (P> 0.05). There was a significant correlation between the appearance of lymphatic vessels and the distant metastasis, lymph node metastasis and Fuhrman nuclear grade (P <0.05), but not with T stage. Survival analysis showed that the overall survival rate of lymphatic vessel density≥16.89 was 50.76%, and the overall survival rate of lymphatic vessel density <16.89 was 63.07% (P> 0.05). The overall survival rate of cancerous lymphatic vessel positive group was 30.86%, and the overall survival rate of lymphatic vessel negative group was 64.36% (P <0.05). Conclusion The lymphatic vessel density in the perineurium has no effect on the prognosis of patients with renal clear cell carcinoma. The lymphatic vessels in the carcinoma are the unfavorable prognostic factors for the patients with clear cell renal cell carcinoma.