结直肠癌组织未分化微血管密度影响其对贝伐单抗联合化疗的敏感性
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江苏省高校优势学科建设工程(JX10231801)


Effect of undifferentiated-vessel microvascular density on sensitivity of bevacizumab plus chemotherapy in patients with advanced colorectal cancer
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    摘要:

    目的:研究结直肠癌组织中微血管的分类及微血管密度(microvascular density,MVD)与贝伐单抗联合化疗敏感性的关系。方法:回顾性分析33例接受贝伐单抗联合化疗的结直肠癌患者,取手术组织的石蜡标本切片,运用免疫组化法分别对血管的CD31-CD34染色,研究肿瘤内微血管的特点,并检测MVD。结果:肠癌组织中CD31阳性的微血管多于CD34阳性的微血管,并以此鉴别出分化血管(CD31+/CD34+)和未分化血管(CD31+/CD34-)两类微血管。治疗敏感组的肠癌未分化血管MVD为10.6 ± 3.1,治疗不敏感组的肠癌组织未分化血管MVD为6.9 ± 3.7,二者差异有统计学意义(P < 0.05)。以MVD中位数为界值,未分化血管MVD高组的中位无进展生存期较未分化血管MVD低组长(9.5个月vs. 3.0个月,P < 0.05)。结论:通过检测肠癌组织中未分化微血管密度可能对贝伐单抗联合化疗的疗效有一定预测作用,对指导个体化治疗有一定帮助。

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    Objective:To study the classification of colorectal cancer tissue microvascular and the relationship between intratumoral microvascular density (MVD) and bevacizumab plus chemotherapy sensitivity in advanced colorectal cancer. Methods:Retrospective analysis was used to analyze 33 cases of advanced colorectal cancer treated with bevacizumab plus chemotherapy. Paraffin-embedded tumor samples were sectioned and stained immunohistochemically for the blood vessel markers CD34 and CD31 to characterize the intratumoral vasculature,then MVD were detected. Results:More blood vessels were stained by anti-CD31 antibody than anti-CD34 antibody. Two distinct types of microvascular were identified in colorectal cancer:differentiated (CD31+/CD34+) and undifferentiated (CD31+/CD34-). In the sensitive group,the number of undifferentiated-vessel MVD was 10.6 ± 3.1,significantly higher than 6.9 ± 3.7 in the insensitive group(P < 0.05). The median of each type of vessel was used as the cutoff value to divide the patients into high- and low-MVD groups. Increased progression-free survival was seen in patients with high undifferentiated-vessel MVD(9.5 months vs. 3.0 months,P < 0.05). Conclusion:CD31+/CD34- MVD can be used as an important biology index to indicate the sensitivity to bevacizumab plus chemotherapy in metastatic colorectal cancer.

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冯 锋,金时代,李 霄,汪云超,吴魏芹,卢凯华,张智弘,黄普文.结直肠癌组织未分化微血管密度影响其对贝伐单抗联合化疗的敏感性[J].南京医科大学学报(自然科学版),2013,(8):1116-1121

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  • 收稿日期:2013-03-11
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  • 在线发布日期: 2013-07-30
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