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目的探讨微血管密度(MVD)及血管内皮生长因子(VEGF)的表达与胃肠道平滑肌肿瘤(GISMT)的性质、恶性程度、转移及预后的关系。方法采用免疫组织化学SP法检测86例GISMT中MVD及VEGF的表达情况。结果MVD、VEGF的表达按平滑肌瘤、低度恶性平滑肌肉瘤、高度恶性平滑肌肉瘤的顺序依次明显增高(P<0.01或P<0.05)。同时,MVD、VEGF的表达与肿瘤良、恶性的生长方式、肿瘤大小、肿瘤中心有无坏死亦有明显关系(P<0.01或P<0.05)。MVD低表达组的5年生存率明显高于高表达组(P<0.01)。而VEGF高表达组的5年生存率则明显低于低表达组(P<0.01)。此外,VEGF阳性表达组的MVD明显高于VEGF阴性表达组的MVD(P<0.01)。结论MVD、VEGF是反映GISMT生物学特性的良好标志物,联合测定可以互补作为判断GISMT性质、恶性程度、转移及预后的客观指标。
Objective To investigate the relationship between the expression of microvessel density (MVD) and vascular endothelial growth factor (VEGF) and the nature, malignancy, metastasis and prognosis of gastrointestinal smooth muscle tumors (GISMT). Methods Immunohistochemical SP method was used to detect the expression of MVD and VEGF in 86 cases of GISMT. Results The expressions of MVD and VEGF were significantly increased in the order of leiomyoma, low grade malignant leiomyosarcoma and high grade leiomyosarcoma (P <0.01 or P <0.05). At the same time, the expression of MVD and VEGF was significantly correlated with the benign and malignant growth, the tumor size and the tumor necrosis (P <0.01 or P <0.05). The 5-year survival rate of MVD low expression group was significantly higher than that of high expression group (P <0.01). The 5-year survival rate of VEGF-overexpression group was significantly lower than that of the low expression group (P <0.01). In addition, the MVD in VEGF positive expression group was significantly higher than that in VEGF negative expression group (P <0.01). Conclusion MVD and VEGF are good markers to reflect the biological characteristics of GISMT. The combined determination can be complementary as an objective index for judging the nature, malignancy, metastasis and prognosis of GISMT.