乳腺癌组织中VEGF-C的表达与淋巴结转移及骨髓微转移的相关性的研究

摘要

【目的】探讨乳腺癌组织中血管内皮生长因子-C（VEGF-C）的表达及其与淋巴结转移和骨髓微转移的关系。【方法】应用免疫组织化学SP法，检测59例乳腺癌组织和10例乳腺良性病变组织中VEGF-C的表达情况；同时抽取相应的骨髓血标本，应用实时定量反转录聚合酶链反应（qRT-PCR）方法检测标本中细胞角蛋白19（CK19） mRNA 的表达水平，并进行相关性分析。【结果】乳腺癌组织中 VEGF-C 阳性表达率62．71％（37/59）及表达程度均明显高于乳腺良性病变组（0％），差异有统计学意义（ P ＜0．05）。乳腺癌淋巴结转移阳性组VEGF-C表达阳性率及表达水平均高于淋巴结转移阴性组（ P ＜0．05）。VEGF-C表达水平与发病年龄、肿瘤大小、病理分型、临床分级、雌激素受体（ER ）水平、孕激素受体（PR ）水平无关，但其表达水平与人类表皮生长因子受体2（HER-2）表达水平显著相关（ P ＜0．05）。CK19 mRNA在乳腺纤维腺瘤患者骨髓标本中未见表达，在乳腺癌患者骨髓血中有34例57．6％（25/59）阳性表达，乳腺癌骨髓微转移阳性组VEGF-C阳性表达率及表达水平均高于骨髓阴性表达组（ P ＜0．05）。骨髓CK19 mRNA表达水平与VEGF-C蛋白表达水平呈正相关（ P ＜0．05）。【结论】乳腺癌患者VEGF-C表达水平与淋巴结转移及骨髓微转移密切相关，提示V EG F-C可能参与了乳腺癌细胞的侵袭和播散。%[Objective] To explore the expression of VEGF-C and its correlation with lymph node (LN ) metastasesandbonemarrow micrometastases(BMM)inbreastcarcinomas .[Methods]S-Pimmunohistochem-istry technique was used to detect the expression of VEGF-C in 59 cases of breast cancer and 10 cases of benign breast lesions .The expression of CK19 mRNA in bone marrow of patients with breast cancer was detected by using real-time quantitive reverse transcriptase polymerase chain reaction (qRT-PCR) .[Results]The positive rate(62 .71% ) and expression degree of VEGF-C in breast cancer were obviously higher than those in the con-trol group(0% ) ,and there was significant difference( P <0 .05) .The positive rate and expression degree of VEGF-C in positive LN metastasis group were higher than those in negative LN metastasis group ( P<0 .05) . The expression of VEGF-C was not correlated with age ,tumor size ,pathologic grade ,clinical stage ,estrogen receptor(ER) and progesterone receptor(PR) ,but significantly correlated with human epidermal growth factor receptor-2(HER-2) ( P<0 .05) .CK19 mRNA was not expressed in bone marrow of patients with breast fi-broadenoma ,but positively expressed in bone marrow of 34 patients with breast cancer (57 .6% ) .The positive rate and expression degree of VEGF-C in positive BMM group were higher than those in negative BMM group (P<0 .05) .CK19 mRNA expression in bone marrow was positively correlated with VEGF-C ( P < 0 .05) .[Conclusion]The expression of VEGF-C is closely associated with LN metastases and BMM in patients with breast cancer ,which indicates that VEGF-C may be involved in the invasion and spread of breast cancer cells .