摘要目的 探讨乳腺癌患者术前血清血管内皮生长因子C(sVEGF-C)水平、组织中环氧化酶2(COX-2)表达与乳腺癌淋巴道转移的关系.方法 采用ELISA法检测68例乳腺癌患者、35例乳腺良性病术前以及12名健康女性sVEGF-C水平.免疫组化SP法检测相应乳腺癌患者组织标本中COX-2表达及淋巴管密度(LMVD);分析sVEGF-C、COX-2及LMVD表达之间的关系.结果 (1)乳腺癌患者术前sVEGF-C水平(49±8)pg/ml显著高于健康女性志愿者(5±3)pg/ml和乳腺良性疾病者(8±4)pg/ml;(2)乳腺癌组织COX-2阳性表达率(44.1%)显著高于乳腺良性疾病(11.4%)(P=0.002);LMVD主要位于癌旁组织,癌巢中少有表达;癌旁组织中LMVD(8.7±4.7)较乳腺良性疾病组织中表达(1.8±1.7)显著增多(P=0.002);(3)在乳腺癌患者sVEGF-C水平增高者中,不但COX-2的表达显著高于sVEGF-C水平正常者COX-2的表达(P=0.024),而且LMVD(8.7±3.9)也显著高于sVEGF-C正常者的LMVD(5.6±3.3)(P=0.039);(4)乳腺癌患者COX-2表达阳性组LMVD(9.5±3.7)明显高于COX-2表达阴性组LMVD(6.0±3.8)(P=0.012);(5)在腋淋巴结转移阳性患者中,sVEGF-C水平、COX-2及LMVD表达均高于腋淋巴结转移阴性组(P值分别为0.025,0.022和0.002).结论 sVEGF-C、COX-2及LMVD在乳腺癌的淋巴道转移中有重要作用,可作为估计乳腺癌有无淋巴结转移的参考指标.

abstractsObjective To investigate the relationship among the serum vascular endothelial growth factor C(sVEGF-C),expression of cyclooxygenase 2(COX-2),and lymph vessel density(LMVD),and to discuss their role in tumor progression and lymphatic metastasis.Methods sVEGF-C level was detected by ELISA in 68 pre-operation breast cancer patients,35 breast benign disease patients,and 12 healthy women.Immunohistochemical method was used to detect the expression of COX-2 and lymphatic vessel endothelial hyaluronidase receptor(LYVE)-1 in the breast cancer tissues and benign disease tissues obtained during operation.Resuits (1)The sVEGF-C level of the pre-operation breast cancer group was (49±8)pg/ml,significantly higher than those of the begin tumor group[(8±4)pg/ml,P=0.045]and the healthy women[(5±3)pg/ml,P=0.003].(2)The COX-2 overexpression positive rate in the breast cancer tissues was 44.1%,significantly higher than that in the begin disease tissues(11.4%,P=0.002).Higher than that in the begin disease tissue;the LMVD overexpression in the breast cancer tissues was mainly located in the para-carcinoma tissue(8.7±4.7),significantly higher than that in the begin disease tissues(1.8±1.7,P=0.002).(3)The COX-2 overexpression rate of the patients with a high sVEGF-C level was significantly higher than that of the patients with a low sVEGF-C level(P=0.024).The LMVD level in the breast cancer of the sVEGF-C high level group was(8.7±3.9),significantly higher than that of the sVEGF-C normal group(5.6 ±3.3,P=0.039).(4)The LMVD in the COX-2 overexpression breast cancer group was 9.5±3.7,significantly higher than that in the COX-2 negative group(6.0±3.8,P=0.012).(5)The sVEGF-C level,COX-2,and LMVD expression in the breast cancer patients with lymphatie metastasis were significantly higher than those in the patients without lymphatic metastasis(P=0.025,0.022,and 0.002 respectively).Conclusion VEGF-C,COX-2,and LMVD play important roles in the lymphatie metastasis of breast cancer.They may be important prognostic factors in evaluating breast cancer lymphatic metastasis.