膀胱移行细胞癌中微血管密度检测的临床意义.DOCVIP

临床医学论文-膀胱移行细胞癌中微血管密度检测的临床意义 ?????????? 作者：廖勇，阎洪涛，王东，龚百生，邹建华，杨红，陈照祥 【关键词】? 膀胱肿瘤 ??? The clinical significances of tumor microvessel density in bladder transitional cell carcinoma 　　ABSTRACT: Objective? To investigate the clinical significances of tumour microvessel density (MVD) in bladder transitional cell carcinoma (BTCC). Methods? Immunohistochemistry (LDP method) was used to study tumor MVD in 61 tissues of primary bladder transitional cell carcinoma and 10 tissues of normal mucosa of bladder. The MVD was analysed with the clinic pathological characters of BTCC. Results? ① The MVD value in tissues of BTCC was significantly higher than that in normal bladder (P0.01). ② The MVD value in tumors with muscular infiltration was significantly higher than in those without muscular infiltration(P0.01). ③ The less bladder carcinoma differentiated, the higher its MVD(P0.01). ④ The recurrent rate was higher in the group of high MVD (P0.01). Conclusion? The MVD values are closely related to the different stages, grades, and recurrence rate of BTCC; therefore, it is a good prognostic marker. 　　KEY WORDS:bladder neoplasma; carcinoma; immunohistochemistry; microvessel density 　　摘要：目的? 探讨检测膀胱移行细胞癌(BTCC)组织中微血管密度(MVD)的临床意义。方法? 应用免疫组织化学LDP法检测61例BTCC，10例正常膀胱组织的MVD。结合临床病理资料进行分析和评价。结果? ①BTCC组织中MVD明显比正常膀胱组织高(P0.01)；②浸润型BTCC组MVD明显高于浅表型BTCC组(P0.01)；③肿瘤分化越差MVD值越高(P0.01)；④高MVD组较低MVD组复发率高(P0.01)。结论? MVD与BTCC组织学分级、临床分期和预后密切相关，是BTCC细胞生物学行为的一种较理想的标志物。 　　关键词：膀胱肿瘤；癌；免疫组化；微血管密度 　　膀胱移行细胞癌(BTCC)是泌尿系统中最常见的恶性肿瘤之一，具有多发、高复发的特点。手术后复发率可高达50%-70%[1]。而新生血管形成是肿瘤生长、转移的基础。肿瘤组织的微血管密度(MVD)能定量地反映出肿瘤血管的生长情况，进而可预示肿瘤生长、转移及复发的趋势。我们采用免疫组织化学LDP法，对BTCC中MVD进行测定，以探讨其临床意义，并对临床、病理资料进行了分析和评价，现报告如下。 　　1? 材料与方法 　　1.1? 材料? 选取我院泌尿科2000年3月至2003年3月手术切除标本61例，所有标本均经病理检查证实为原发性膀胱移行细胞癌(BTCC)。男45例，女16例，年龄25-93岁，平均59.6岁，术前均未作任何治疗。病理分级按WHO标准，G1级13例，G2级27例，G3级21例。临床分期按UICCTNM标准：浅表性肿瘤Tis-T1期33例，浸润性肿瘤T2-T4期28例。肿瘤数目：单发39例，多发22例。其中有随访结果的56例，术后随访10-59个月，复发18例。另取10例正常膀胱黏膜作内对照。 　　1.2? 方法? 免疫组织化学染色采用LDP法，鼠抗人CD34单克隆抗体及二抗EnvisionTM试剂盒均为DAKO公司产品。操作步骤