VEGF-C And LYVE-1 In Epithelial Ovarian Tumors And Their Clinical Significance

BACKGROUND Invasion and metastasis is the malignant behavior of tumors, also the major causer that resulting in the death of gynecological cacer patients. Ovarian cancer is a common gynecological cancer, that incidence hidden,70% patients in the late stage when found and the refractory recurrence and metastasis is ofen found. Epithelial ovarian tumors accounts for 50%-70% in the primary ovarian tumors. Many experts at abroad and home dedicated studying the early discovery and prognosis factors.In the rencent years,the role of lymphangiogenesis in the proliferation and metastasis of the tumors becomes the hot spot with the discovery of lymphatic specific markers. The lymphatic metastasis is an important route for the epithelial ovarian tumors metastasis,the lymph node involvement or not is an important factor affecting prognosis.VEGF-C is the member of the vascular endothelial growth factors (VEGF)famly and promotes tumors lymphangiogenesis and lymph node metastasis by combining with its receptor (VEFGR-3).LYVE-1 is a receptor of hyaluronan (HA), widely used in tumor lymphangiogenesis as a reliable marker of lymphatic vessels.The text analyzed the relationship between their expression and the clinicopathological factors by detecting their expression in epithelial ovarian tumors.PURPOSE The text investigated the role and the singnificance of the VEGF-C and LYVE-1 in epithelial ovarian tumors by detecting their expression and the relationship between their expression and the clinicopathological factors.Methods The immunohistochemical SP method detected VEGF-C expression and LYVE-1 positive lymphatic vessel density (Lymphatic vessels density, LVD) of 61 cases of surgical specimens from patients with epithelial ovarian tumors and analyzed the relationship between their expression and clinical pathological factors. In the specimens 43 patients with epithelial ovarian cancer, of which 25 cases of serous cystadenocarcinoma, mucinous cystadenocarcinoma in 6 cases,7 cases of endometrial carcinoma, clear cell carcinoma in 2 cases, undifferentiated carcinoma in 3 cases.All the cases were not receiving preoperative radiotherapy and chemotherapy.26 cases with lymph node metastasis, no lymph node metastasis in 17 cases; clinical stage of the patients was in accordance with International Federation of Gynecology and Obstetrics (FIGO,2000) standard. In which 6 cases of stageⅠ,Ⅱperiod of 4 cases,Ⅲperiod of 28,Ⅳperiod of 5;histologic grade:G1 9 cases, G219 cases, G315 cases; 8 cases of borderline ovarian tumors, including borderline serous cystadenoma 5 cases and borderline mucinous cystadenoma in 3 cases; ovarian cystadenoma in 10 cases, of which 6 cases of serous cystadenoma, mucinous cystadenoma in 5 cases. VEGF-C positive staining was yellow or brown particles seen in the cytoplasm, according to the proportion of positive cells divided into:-(no positive cells),+(0-5%positive cells),++(5%-50%positive cells),+++(>50%positive cells).++-+++was judged as positive. The positive lymphatic vessels were the strip, gap-like structure or a clear lumen by LYVE-1 positive brown staining of endothelial cells forming. The dense area of positive lymphatic vessels within and around the tumor was regarded as "hot spot" areas with low magnification, Counting the average number of five view of positive lymphatic vessels with high magnification was LVD (lymphatic vessel density, Lymphatic vessels density).Results 1.The expression of VEGF-C in the epithelial ovarian tumors By immunohistochemistry, VEGF-C can be seen in 61 cases of epithelial ovarian tumors. The result showed that VEGF-C in ovarian cancer positive rate was 65.12%(28/43), in ovarian borderline tumors and benign tumors was 25%(2/8) and 10%(1/10), the deviation was significant (P<0.05).2.The expression of LVD in the epithelial ovarian tumors LVD in the epithelial ovary carcinoma was 26.90±1.85; borderline ovarian tumor LVD25.51±1.43; ovarian cystadenoma LVD23.29±1.49.The expression in epithelial carcinoma was higher than in borderline tumors and benign tumors (P<0.01),3. The relationship between the expression VEGF-C and clinicopathological factors The positive rate of VEGF-C in the clinical stageⅢ,Ⅳwas 80.65%(25/31),the expression clinical stageⅠ,Ⅱwas 41.67%(5/12), the deviation was significant (P<0.05).With lymph node metastasis of the tumor the expression of VEGF-C73.08%(19/26) higher than that without lymph node metastasis35.29%(6/17) (P<0.05). VEGF-C expression in epithelial ovarian cancer had little relationship to age, histological grade, histological type (P> 0.05), and had obvious relationship to clinical stage, lymph node metastasis (P<0.05).4. The relationship between the expression LVD and clinicopathological factors The LVD of Clinical stageⅢ,Ⅳ26.89±1.84 was higher than the clinical stageⅠ,Ⅱ25.50±1.66)(P<0.05), with lymph node metastasis LVD 26.89±1.84 was higher than that without lymph node metastasis LVD 25.59±1.66 (P<0.05). LVD in ovarian cancer patients with epithelial ovarian cancer had little relationship to patient's age, histological grade, histological type (P> 0.05), had obvious relationship to clinical stage, lymph node metastasis (P<0.05).Conclusion:1.VEGF-C induced lymphangiogenesis in epithelial ovarian tumor, lymphatic vessels density(LVD) promoting and was related to lymphatic metastasis. 2.VEGF-C in human ovarian promoted tumor cell proliferation, invasion and metastasis, was related to epithelial ovarian cancer prognosis.