摘要目的 探讨卵巢癌血管生成拟态这一独特的肿瘤营养供应模式及其与卵巢癌临床病理特征和预后的关系.方法 收集临床和随访资料完整的卵巢癌患者经手术切除的石蜡标本共84例,分析卵巢癌的临床病理特征;采用CD31/PAS双重染色法将84例卵巢癌组织分为有血管生成拟态组和无血管生成拟态组,分析血管生成拟态与患者临床病理特征及肿瘤转移和预后之间的关系;并采用免疫组织化学(SP法)检测两组卵巢癌组织中血管内皮生长因子(VEGF)、基质金属蛋白酶(MMP)-2、MMP-9、E-cadherin、β-catenin和波形蛋白的表达情况.结果 84例卵巢癌患者中有36例存在血管生成拟态,84例卵巢癌的FIGO分期、组织学类型、病理学分级和转移情况与血管生成拟态的形成密切相关(X2值分别为10.30、20.01、8.16、9.75,P值均小于0.05).VEGF、MMP-2、MMP-9、E-cadherin和β-catenin在血管生成拟态组卵巢癌组织中呈高表达状态,在无血管生成拟态组组织中呈低表达状态.生存分析发现有血管生成拟态的患者生存时间比无血管生成拟态患者短(P=0.04).结论 卵巢癌细胞形成血管生成拟态的能力与其恶性度有关,恶性度越高形成血管生成拟态的能力越强,血管生成拟态是卵巢癌患者预后的重要指标,VEGF、MMP-2、MMP-9与卵巢癌血管生成拟态的形成有着密切的关系.

abstractsObjective To explore the existence of vasculogenic mimicry(VM)in ovarian carcinoma and its correlationship with the clinicopathologic features and prognosis of the tumor.Methods A total of 84 ovarian carcinoma cases were collected with complete clinical and prognostic data.CD31 immunohistochemistry and PAS special stain were used to investigate VM in the tumor tissue.Immunohistochemical staining of VEGF,MMP-2,MMP-9,E-cadherin,β-catenin,and Vimentin were used to explore the pathogenesis of VM.Results Totally 36 of 84 cases exhibited evidence of VM.FIGO classification,pathologic grades and histological types were significantly different between the VM and non-VM groups.Expression of VEGF,MMP-2,MMP-9,E-cadherin and β-catenin were higher in the VM group than in the non-VM group.Kaplan-Meier survival curve analysis showed that cases of the VM group had a lower survival rate than that of the non-VM group(P=0.04).Conclusions Vasculogenic mimicry exists in ovarian carcinoma.Ovarian carcinomas with a high grade malignancy have a high incidence of VM formation,a higher incidence of metastases and a lower survival rate.High expression of MMP-2 and MMP-9 may contribute to the formation of VM in the ovarian cancer.