本文選題：D2-40　切入點：CD34　出處：《桂林醫(yī)學院》2010年碩士論文

【摘要】：目的D2-40是淋巴管內皮細胞的一種高度特異性標志,可用于識別正常和腫瘤組織中的淋巴管,而CD34是新生血管的主要特異標志。腫瘤中高表達VEGF-C可能促進血管和淋巴管新生。我們應用免疫組織化學技術檢測鼻咽癌組織中淋巴管特異性標志物D2-40、CD34、VEGF-C和VEGFR-3蛋白的表達,同時測定淋巴管密度和微血管密度,分析它們之間相互關系及與鼻咽癌淋巴結轉移的關系。 方法選取桂林醫(yī)學院附屬醫(yī)院2004年6月—2006年9月臨床病理資料完整的鼻咽癌活檢標本(蠟塊包埋)61例,并取30例同期就診于該醫(yī)院被病理診斷為輕度鼻咽粘膜炎癥鼻咽組織(蠟塊包埋)作為對照。采用淋巴管內皮特異性標記物商品化試劑D2-40單克隆抗體、血管內皮細胞特異性標記物CD34單克隆抗體,基于免疫組織化學Supervision法分別檢測上述組織標本對D2-40及CD34的表達,測定淋巴管密度(LVD)和微血管密度(MVD);并應用VEGF-C和VEGFR-3商品化試劑盒分別測定該兩分子的蛋白表達,以SPSS11.5軟件將檢測的上述參數與患者各項臨床病理指標進行統(tǒng)計學分析。 結果1.D2-40在鼻咽癌的組織中呈不同程度表達,淋巴結轉移的鼻咽癌組織LVD顯著高于無淋巴結轉移組(11.01±2.99 V.S 8.83±1.78 P0.05),且鼻咽癌LVD與淋巴結轉移呈密切。鼻咽癌瘤周LVD顯著高于瘤內(10.34±2.98 V.S 6.25±2.32 P0.05),瘤周LVD計數與淋巴結轉移存在密切關系。LVD的計數在鼻咽癌不同年齡、性別、T分期(T_(1-2) V.S T_(3-4))及其臨床分期之間的差異均無統(tǒng)計學意義。 2. VEGF-C在鼻咽癌組織中陽性表達率為68.85%。VEGF-C不同表達程度分組之間的瘤周LVD計數差異有統(tǒng)計學意義,兩者之間存在密切關系(10.45±4.99 V.S 7.01±2.99 P0.05)。VEGF-C的表達在臨床分期(I-II V.S III-IV)的比較有統(tǒng)計學意義,VEGF-C表達在鼻咽癌不同年齡、性別、T分期的差異均無統(tǒng)計學意義。 3.VEGFR-3在鼻咽癌組織細胞膜及胞漿中表達,而在正常鼻咽組織中無表達。存在淋巴結轉移的鼻咽癌組織表達VEGFR-3陽性率和無淋巴結轉移的鼻咽癌VEGFR-3陽性率比較具有統(tǒng)計學意義(11.69±4.58 V.S 6.68±2.53 P0.05)。VEGFR-3表達在不同臨床分期(I-II V.S III-IV)的比較有統(tǒng)計學意義(3/15 V.S 35/46 P0.05),在不同年齡、性別、T分期之間的差異均無統(tǒng)計學意義。 4.CD34在鼻咽癌組織和正常鼻咽組織中有不同程度表達,鼻咽癌組織中MVD顯著高于鼻咽正常組織,存在淋巴結轉移的鼻咽癌組織MVD顯著高于鼻咽癌無淋巴結轉移組,且鼻咽癌MVD與淋巴結轉移呈密切(7.68±4.11 V.S3.45±2.21 P0.05)。鼻咽癌瘤周MVD顯著高于瘤內(10.07±5.38 V.S 3.22±3.12 P0.05)。CD34表達水平在鼻咽癌不同年齡、性別、T分期之間的差異均無統(tǒng)計學意義,而與臨床分期具有統(tǒng)計學意義。 5.鼻咽癌組織中LVD和MVD的計數關系密切,呈一致性趨勢。 結論微淋巴管及新生血管主要存在鼻咽癌瘤周,瘤內脈管較少;鼻咽癌瘤周LVD及MVD顯著高于腫瘤內及癌旁正常組織,且與淋巴結轉移顯著相關,提示鼻咽癌淋巴管及血管形成與腫瘤進展相關。
[Abstract]:Objective D2 - 40 is a highly specific marker of lymphatic endothelial cells , which can be used to identify lymphatic vessels in normal and tumor tissues , while CD34 is the main specific marker of angiogenesis . The expression of VEGF - C , CD34 , VEGF - C , and VEGFR - 3 proteins in nasopharyngeal carcinoma tissues is detected by immunohistochemistry . The relationship between lymphatic vessel density and microvessel density is analyzed , and the relationship between them and lymph node metastasis of nasopharyngeal carcinoma are analyzed .

Methods From June 2004 to September 2006 , 61 cases of nasopharyngeal carcinoma biopsy specimens ( paraffin embedded ) were selected from the Affiliated Hospital of Guilin Medical College from June 2004 to September 2006 .

Results 1 . The LVD of nasopharyngeal carcinoma was significantly higher than that in non - lymph node metastasis group ( 11.01 鹵 2.99 V . S 8.83 鹵 1 . 78 P0.05 ) . LVD was significantly higher in NPC than in tumor ( 10.34 鹵 2.98 V . S 6.25 鹵 2.32 P0.05 ) . LVD counts were not significant in NPC with different ages , sex , T stage ( T _ ( 1 - 2 ) V . S T _ ( 3 - 4 )) and clinical stage .

2 . The positive expression rate of VEGF - C in nasopharyngeal carcinoma was 68.85 % . There was a significant difference between the expression of VEGF - C and the degree of expression of VEGF - C . There was a close relationship between the two groups ( 10.45 鹵 4.99 V.S 7.01 鹵 2.99 P0.05 ) . The expression of VEGF - C was statistically significant in clinical stage ( I - II V . S III - IV ) , and VEGF - C expression was not statistically significant at different age , sex and T stage of NPC .

3 . The positive rate of VEGFR - 3 and the positive rate of VEGFR - 3 in NPC with lymph node metastasis were statistically significant ( 11.69 鹵 4.58 V.S 6.68 鹵 2.53 P0.05 ) . The expression of VEGFR - 3 was statistically significant ( 3 / 15 vs . S 35 / 46 P 0.05 ) in different clinical stages ( I - II V . S III - IV ) .

4 . The MVD was significantly higher in NPC tissues and normal nasopharyngeal tissues , and MVD in NPC was significantly higher than that in NPC without lymph node metastasis . MVD was closely related to lymph node metastasis ( 7.68 鹵 4.11 V.S 3.45 鹵 2.21 P0.05 ) . MVD in NPC was significantly higher than that in the tumor ( 10.07 鹵 5.38 V.S 3.22 鹵 3.12 P0.05 ) . There was no significant difference between the expression level of CD34 and the age , sex and T stage of NPC .

5 . The counts of LVD and MVD in NPC tissues were closely related and showed a consistent trend .

Conclusion The lymphatic vessels and angiogenesis in nasopharyngeal carcinoma were significantly higher than those in the tumor and adjacent to the adjacent tissues and were significantly correlated with lymph node metastasis , suggesting that the lymphatic vessels and angiogenesis in NPC were correlated with the tumor progression .

【學位授予單位】：桂林醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R739.63

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