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中华乳腺病杂志(电子版)

中华乳腺病杂志(电子版) ›› 2014, Vol. 08 ›› Issue (04) : 248 -252. doi: 10.3877/cma. j. issn.1674-0807.2014.04.005

论著

血管内皮生长因子及色素上皮衍生因子在乳腺癌中的表达及临床意义
周丹1,2, 张敏3, 许鹏程3, 于洋3, 张琳3, 唐廷勇4, 吴爱国1,†()   
  1. 1.510282 广州, 南方医科大学珠江医院普通外科
    2.528100 佛山,中山大学附属佛山医院,佛山市第一人民医院乳腺外科
    3.南方医科大学基础医学院组胚教研室
    4.广东医学院附属三水医院普通外科
  • 收稿日期:2014-03-17 出版日期:2014-08-01
  • 通信作者: 吴爱国
  • 基金资助:
    佛山市卫生局医学科研立项课题(2014197)

Expressions of vascular endothelial growth factor and pigment epithelium-derived factor in breast cancer and their clinical significance

Dan Zhou1, Min Zhang1, Pengcheng Xu1, Yang Yu1, Lin Zhang1, Tingyong Tang1, Aiguo Wu1,†()   

  1. 1.Department of General Surgery, Zhujiang Hospital, Southern Medical University,Guangzhou 510582, China
  • Received:2014-03-17 Published:2014-08-01
  • Corresponding author: Aiguo Wu
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引用本文：

周丹, 张敏, 许鹏程, 于洋, 张琳, 唐廷勇, 吴爱国. 血管内皮生长因子及色素上皮衍生因子在乳腺癌中的表达及临床意义[J]. 中华乳腺病杂志(电子版), 2014, 08(04): 248-252.

Dan Zhou, Min Zhang, Pengcheng Xu, Yang Yu, Lin Zhang, Tingyong Tang, Aiguo Wu. Expressions of vascular endothelial growth factor and pigment epithelium-derived factor in breast cancer and their clinical significance[J]. Chinese Journal of Breast Disease(Electronic Edition), 2014, 08(04): 248-252.

目的

探讨血管内皮生长因子(VEGF)、色素上皮衍生因子(PEDF)在乳腺癌组织中的表达水平及其与乳腺癌病理特征的关系。

方法

采用Envision 免疫组织化学方法对20 例乳腺良性病变组织(纤维腺瘤)、85 例乳腺浸润性导管癌组织中的VEGF、PEDF 和CD34 表达情况进行检测。 CD34 表达反映微血管密度(MVD)。 计数资料采用χ2 检验, Spearman 等级相关分析方法进行相关性分析。

结果

VEGF 在乳腺癌组织中的阳性表达率为71.7%(61/85),高于在乳腺良性组织中的阳性表达率40%(8/20),差异有统计学意义(χ2=9.959, P=0.002);PEDF 在乳腺癌组织中的阳性表达率为41.2%(35/85),低于在乳腺良性组织中的阳性表达率90%(18/20),差异有统计学意义(χ2 =19.683, P=0.000)。 在乳腺癌组织中VEGF 与PEDF 表达呈负相关(r=-0.365,P=0.019)。 乳腺癌组织中VEGF表达与肿瘤直径(χ2=26.31,P=0.000)、TNM 分期(χ2=5.428,P=0.020)、淋巴结转移有关(χ2=5.368,P=0.021);PEDF 表达与TNM 分期(χ2=8.584, P=0.003)、肿瘤直径(χ2=11.079,P=0.001)、绝经状态(χ2=4.507,P=0.034)、ER 状态有关(χ2 =3.974,P=0.046)。 MVD 值在PEDF 阴性组高于阳性组(38.67±6.52 比22.56±5.16,Z=-0.984,P=0.000),在VEGF 阳性组则高于阴性组(38.78±6.28 比25.36±5.12,Z=-0.972,P=0.000)。

结论

乳腺癌组织中存在PEDF、VEGF 的表达相关性,且与MVD相关,对认识乳腺癌的生物学特性以及指导乳腺癌的诊疗具有重要意义。

关键词: 乳腺肿瘤, 血管内皮生长因子, 色素上皮衍生因子, 微血管密度

Objective

To investigate the expressions of vascular endothelial growth factor (VEGF)and pigment epithelium-derived factor (PEDF) in breast cancer tissue, and their relationship with the clinicopathological characteristics of breast cancer patients.

Methods

The expressions of VEGF, PEDF and CD34 were detected in 20 cases of benign breast diseases (fibroadenoma) and 85 cases of invasive ductal carcinoma by Envision immunohistochemical method. CD34 expression reflected microvessel density(MVD).The numeration data were analyzed by Chi-square test, and Spearman rank test was used for correlation analysis.

Results

The positive expression rate of VEGF was 71.7% (61/85) in breast cancer tissue,significantly higher than 40%(8/20)in breast benign tissue (χ2=9.959, P=0.002); The positive expression rate of PEDF was 41.2% (35/85)in breast cancer tissue, significantly lower than 90% (18/20)in breast benign tissue (χ2 =19.683, P=0.000); VEGF expression was negatively correlated with PEDF expression(r=-0.365, P=0.019). In invasive ductal carcinoma, the expression of VEGF was significantly related with tumor diameter (χ2=26.31,P=0.000), TNM stage (χ2=5.428,P=0.020), and lymphatic metastasis (χ2=5.368,P=0.021); the expression of PEDF was significantly related with tumor diameter (χ2 =11.079,P=0.001), TNM stage (χ2 =8.584,P=0.003), menstruation status(χ2 =4.507,P=0.034), and ER status(χ2=3.974,P=0.046). The MVD value in PEDF negative was higher than that in PEDF positive group(38.67±6.52 vs 22.56±5.16,Z=-0.984,P=0.000); The MVD value in VEGF positive was higher than that in VEGF negative group (38.78±6.28 vs 25.36±5.12,Z=-0.972,P=0.000).

Conclusion

There is a correlation between PEDF and VEGF expression in breast cancer tissue, and the expressions of the two factors are also related to MVD, which may provide reference to the physicians in recognizing the biological characteristics of breast cancer and guiding the diagnosis and treatment of breast cancer.

Key words: Breast neoplasms, Vascular endothelial growth factor, Pigment epithelium-derived factor, Microvessel density
图1 VEGF 在乳腺浸润性导管癌中的表达( ×400) 着色位于细胞质中,呈棕黄色颗粒;VEGF:血管内皮生长因子
图2 PEDF 在乳腺浸润性导管癌中的表达( ×400) 着色位于细胞质和细胞膜中,呈棕黄色颗粒;PEDF:色素上皮衍生因子
图3 乳腺浸润性导管癌血管中CD34 阳性内皮细胞表达( ×400)
表1 乳腺癌患者的临床病理参数与PEDF、VEGF 表达情况的关系
项目 例数 VEGF表达 χ 2值 P值 PEDF表达 χ 2值 P值
阳性 阴性 阳性 阴性
年龄 1.425 0.233 0.762 0.382
≥60岁 17 6(35.3) 11(64.7) 6(35.3) 11(64.74)
＜60岁 68 35(51.5) 33(48.5) 32(47.0) 36(53.0)
肿瘤直径 26.31 0.000 11.079 0.001
＜2 cm 31 12(38.7) 19(61.3) 18(58.0) 13(41.9)
≥2 cm 54 49(90.7) 5(9.25) 12(22.2) 42(77.8)
TNM分期 5.428 0.020 8.584 0.003
Ⅰ+Ⅱ期 55 30(54.5) 25(45.5) 29(52.7) 26(47.3)
Ⅲ期 30 24(80.0) 6(20.0) 6(20.0) 24(80.0)
淋巴结转移 5.368 0.021 0.082 0.774
有 47 36(76.6) 11(23.4) 20(42.6) 27(57.4)
无 38 20(65.8) 18(47.4) 15(39.5) 23(60.5)
组织学分级 0.071 0.790 0.389 0.533
Ⅰ+Ⅱ级 55 40(72.7) 15(27.3) 24(43.6) 31(56.4)
Ⅲ级 30 21(70.0) 9(30.0) 11(36.7) 19(63.3)
绝经状态 0.005 0.946 4.507 0.034
绝经前 46 38(82.6) 8(17.4) 17(37.0) 29(63.0)
绝经后 39 32(82.1) 7(17.9) 18(46.2) 11(53.8)
ER 1.313 0.252 3.974 0.046
阳性 52 35(67.3) 17(32.7) 32(61.5) 20(38.5)
阴性 33 26(78.8) 7(21.2) 13(39.4) 20(60.6)
表2 乳腺癌组织中PEDF 与VEGF 表达相关性
VEGF PEDF 合计
+ -
+ 20 41 61
- 15 9 24
合计 35 50 85
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