论文部分内容阅读
目的 :探讨新辅助化疗前后同一胃或肠肿瘤患者微血管密度 (MVD)、增殖细胞核抗原 (PCNA)及血管内皮细胞因子 (VEGF)有否变化、变化后的情况及与预后的关系。方法 :选择确诊为胃或肠肿瘤患者 59例为观察组 ,其中胃癌 2 8例 ,大肠癌 31例 ,分别检测同一患者化疗前病理检查标本及经动脉新辅助化疗后手术切除标本中MVD、PCNA及VEGF的表达。同期设未行新辅助化疗的胃或肠肿瘤患者 50例为对照。结果 :新辅助化疗后同一患者MVD、PCNA有降低 ,P <0 .0 5 ,有显著性差异 ;而VEGF阳性表达仅有部分增加 ,P >0 .0 5 ,无显著性差异。新辅助化疗前VEGF与MVD、PCNA呈正相关 (r=0 .2 1 ,0 .1 9,P <0 .0 5)。新辅助化疗后VEGF与MVD、PCNA无相关性 (r=0 .31 ,0 .2 5 ,P >0 .0 5)。新辅助化疗后患者 3年内复发 1 3例 ,对照组 3年内复发 2 3例 ,两组病例统计学检验 ,P <0 .0 5,有显著性差异。复发者MVD、PCNA明显高于未复发者 ,P <0 .0 5 ,有显著性差异。对照组手术前后MVD、PCNA及VEGF无变化。结论 :新辅助化疗可以降低MVD及PCNA的表达。新辅助化疗后MVD、PCNA减少是降低肿瘤患者术后复发率的重要因素。同时提示新辅助化疗后单纯的VEGF表达对预后并无临床意义。经新辅助化疗后 ,MVD、PCNA变化不明显的患者预后不良。
Objective: To investigate the changes of microvessel density (MVD), proliferating cell nuclear antigen (PCNA) and vascular endothelial cell factor (VEGF) in patients with the same gastric or intestinal tumor before and after neoadjuvant chemotherapy. The changes and their relationship with prognosis were analyzed. Methods: Fifty-nine patients diagnosed as gastric or intestinal cancer were selected as the observation group, including 28 cases of gastric cancer and 31 cases of colorectal cancer. MVD and PCNA were detected in the same patient before operation and in surgical resection after aortic neoadjuvant chemotherapy And VEGF expression. The same period set no neoadjuvant chemotherapy in patients with gastric or intestinal tumors in 50 cases as a control. Results: The same patients after neoadjuvant chemotherapy decreased MVD, PCNA, P <0. 05, there was a significant difference; while VEGF-positive expression was only partially increased, P> 0.05, no significant difference. Neoadjuvant chemotherapy before VEGF and MVD, PCNA was positively correlated (r = 0.21, 0.19, P <0.05). Neoadjuvant chemotherapy VEGF and MVD, PCNA no correlation (r = 0.31, 0.25, P> 0.05). Neoadjuvant chemotherapy in patients relapsed after 13 cases of 13 cases, the control group relapsed within 3 years 23 cases, two groups of statistical tests, P <0. 05, a significant difference. The recurrence of MVD, PCNA was significantly higher than those without recurrence, P <0. 05, a significant difference. The control group before and after MVD, PCNA and VEGF did not change. Conclusion: Neoadjuvant chemotherapy can reduce the expression of MVD and PCNA. Neoadjuvant chemotherapy after MVD, PCNA reduction is to reduce the recurrence rate of tumor patients an important factor. At the same time, suggesting that the simple VEGF expression after neoadjuvant chemotherapy is not clinically significant prognosis. After neoadjuvant chemotherapy, MVD, PCNA did not change significantly in patients with poor prognosis.