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全直肠系膜切除术切缘血管内皮生长因子检测的临床意义
http://www.100md.com 战学雷, 田素礼
直肠癌;直肠系膜远端切缘;直肠系膜周围切缘;盆筋膜壁层;全直肠系膜切除术;血管内皮生长因子,战学雷,田素礼,通讯作者:,电话:,收稿日期:,接受日
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     战学雷, 田素礼, 哈尔滨医科大学附属第二医院普外三科 黑龙江省哈尔滨市 150086

    通讯作者:战学雷, 150086, 黑龙江省哈尔滨市学府路246号, 哈尔滨医科大学附属第二医院普外三科. zhanxuelei@126.com

    电话:0451-86605575

    收稿日期:2005-05-28 接受日期:2005-06-13

    Clinical significance of detection for vascular endothelial growth factor in resection margin following total mesorectal excision

    Xue-Lei Zhan, Su-Li Tian

    Xue-Lei Zhan, Su-Li Tian, the Third Department of General Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China

    Correspondence to: Xue-Lei Zhan, Department of General Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China. zhanxuelei@126.com

    Received: 2005-05-28 Accepted: 2005-06-13

    Abstract

    AIM: To investigate the expression and its significance of vascular endothelial growth factor (VEGF) in the resection margin following total mesorectal excision (TME) for human rectal cancer.

    METHODS: VEGF was detected in the tissue specimens of cancer, distal mesorectal margin (DMM), circumferential resection margin (CRM) and outer pelvic fascia from 60 rectal cancer patients received TME. The pathological data were retrospectively analyzed.

    RESULTS: VEGF expression was significantly higher in the tissues of rectal cancer than that in the normal tissues (54/60 vs 2/20, P <0.001). VEGF was also expressed in tissues of CRM (9/60). However, no VEGF expression was detected in the tissues of DMM and outer pelvic fascia. VEGF expression was closely related with the differentiation degree, Dukes staging and lymph node metastasis (P <0.05 or P <0.01).

    CONCLUSION: VEGF is highly expressed in tissues of rectal cancer, and negatively or weakly positively expressed in DMM and CRM.

    Key Words: Rectal cancer; Distal mesorectal margin; Circumferential resection margin; Outer pelvic fascia; Total mesorectal excision; Vascular endothelial growth factor

    Zhan XL, Tian SL. Clinical significance of detection for vascular endothelial growth factor in resection margin following total mesorectal excision. Shijie Huaren Xiaohua Zazhi 2005;(18):2278-2281

    摘要

    目的: 探讨血管内皮生长因子(VEGF)在直肠癌及其切缘的表达及其临床意义.

    方法: 取实施TME的60例直肠癌患者直肠癌组织(Ⅰ)、直肠系膜远端切缘(Ⅱ)、直肠系膜周围切缘(Ⅲ)、盆筋膜壁层(Ⅳ)病理标本,采用免疫组化SP法对标本进行VEGF检测; 并回顾性分析临床病理学资料.

    结果: 直肠癌组织中VEGF高度表达(54/60),肿瘤相对的盆筋膜脏层(直肠系膜周围切缘)中有VEGF存在(9/60),在直肠系膜远端切缘及盆筋膜壁层标本中未见VEGF表达. VEGF在直肠癌组织中的表达有高度特异性. VEGF表达与直肠癌分化程度、Dukes分期及淋巴结转移密切相关(P<0.05或P<0.01).

    结论: VEGF在直肠癌组织中高度表达,直肠远端系膜切缘及直肠系膜周围切缘不表达或表达为弱阳性.

    关键词: 直肠癌;直肠系膜远端切缘;直肠系膜周围切缘;盆筋膜壁层;全直肠系膜切除术;血管内皮生长因子

    战学雷,田素礼. 全直肠系膜切除术切缘血管内皮生长因子检测的临床意义. 世界华人消化杂志 2005;(18):2278-2281

    0 引言

    包括直肠癌在内的实体肿瘤的生长与转移依赖血管新生的理论已被大量实验和临床研究证实,血管内皮生长因子(vascular endothelial growth factor,VEGF)作为最重要的促血管生成因子,在肿瘤发生、发展中起重要作用[1-4].全直肠系膜切除术(total mesorectal excision,TME)已成为一种标准的直肠癌根治技术,已被越来越多的外科医生应用于临床[5-7] ......

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