The Esophageal TP And VEGF Expression And Its Relationship With Clinicopathological Features And Prognosis

Objective: To determine the expression of vascular endothelial growthfactor, platelet-derived endothelial cell growth factor PD-ECGF/TP and tumormicrovessel density in tumor, analysis of its correlation with clinicopatho-logical factors and prognosis in esophageal cancer, evaluate the role ofcombined detection predicting the prognosis of patients with esophagealcancer.Methods: Selected123cases of eso phageal paraffin-embeded samples forexperimental specimens from the Fourth of Hebei Medical University, January2000to November2000, VEGF, TP and MVD counts of123cases ofesophageal was detected by SP immunohistochemistry. Collected the data ofclinical pathology and follow-up, to analyze the relationship between VEGF,TP,MVD and clinicopathological factors by using statistical methods. Thepatients were grouped according to the expression levels of various indicatorsand the survival analysis of esophageal cancer patients were done by usingKaplan-Mier method(log-rank test)and cox regression models(univariate andmultivariate analysis),and summarize the main factors impacted on survival.Result:1VEGF,TP and MVD determination:MVD value of123esophageal casesis (45.88±21.06)/HP.1.1VEGF positive group was73cases, the negative group was50cases,twosets of MVD was (50.79±21.24)/HP vs (38.70±18.78)/HP. MVD of positivegroup was significantly higher than the one of negative group(t=-3.249,P<0.01) and the correlation between the expression of VEGF positive cells andmicrovessel density in tumor tissue was a significant positive (r=0.422, p<0.001).1.2TP positive group was63cases, the negative group was60cases, two sets of MVD was(51.13±18.95)/HP vs(40.37±21.90)/HP. MVD of positivegroup was significantly higher than the negative group(t=-2.918,P<0.01) andthe correlation between expression of TP positive cells and microvesseldensity in tumor tissue was a significant positive (r=0.274, p<0.01).1.3TP,VEGF were positive in44cases,MVD in as (55.68±19.46)/HP,31cases were negative and MVD (37.55±21.77)/HP, VEGF/TP (-/+or+/-)were48cases and MVD(42.27±18.80)/HP. The difference of MVD among thethree groups was significant (F=8.922, P<0.001).2The correlation between the expression of VEGF in esophageal carcinomawith clinicopathological factors.VEGF expression of different clinical pathological condition in esophagealcancer tissue show: The expression of VEGF in the group of lymph nodemetastasis in esophageal cancer was significantaly higher than that withoutlymph node metastasis(χ2=4.675, P<0.05).VEGF expression of tumor cellpoorly differentiated group was significantly higher than that well-differentiated group(χ2=8.532P<0.01);tumor size≥3cm group wassignificantly higher than the tumor size<3cm group(χ2=12.183, P<0.001);lesion by T stage, the depth of invasion (T3+T4) group,VEGFexpression was significantly higher than (Tis+T1+T2)group(χ2=20.192,P<0.001);the expression of VEGF among the lowerthoracic,the middlethoracic and the upper thoracic+cervical grouping were significantlydifferent(χ2=14.533,P<0.01) and not significant with the patient's gender,age,pathological type and the presence of distant metastasis.3The correlation between TP expression and clinicopathological factorsin esophageal cancerTP expression of different clinical pathological situations in esophagealcarcinoma shows:The expression of TP in the group of lymph node metastasisin esophageal cancer was significantaly higher than that without lymph nodemetastasis (χ2=7.691, P <0.01). TP expression of tumor cell poorlydifferentiated group was significantly higher than that well-differentiatedgroup(χ2=9.898, P<0.01);tumor size≥3cm group was significantly higher than the tumor size<3cm group(χ2=18.849,P<0.001);lesion by T stage, thedepth of invasion(T3+T4)group,TP expression was significantly higherthan (Tis+T1+T2)group(χ2=5.083,P<0.05);the expression of TP amongthe lowerthoracic, the middle thoracic and the upper thoracic+cervicalgrouping were significantly different(χ2=14.293,P<0.01) and not significantwith the patient's gender,age,pathological type and the presence of distantmetastasis.4The correlation between TP expression and clinicopathological factors inesophageal cancerMVD counts of different clinical pathological situations in esophagealcarcinoma shows: esophageal carcinoma MVD in lymph node metastasis wassignificantly higher than those group without lymph node metastasis(t=-3.969,P<0.001);MVD in tumor cell poorly differentiated group was significantlyhigher than that well-differentiated group(t=-3.329, P<0.01);MVD in lesiondepth of invasion (Tis+T1+T2) group was significantly higher than(T3+T4) group (t=-2.704,P <0.01); has nothing to do with thepatient's gender, age, lesion location, pathological type and presence ofdistant metastasis.5Analysis of TP, VEGF and MVDThe analysis of MVD between TP and VEGF:VEGF and MVD waspositively correlated(r=0.422, p <0.01);TP and VEGF was positivelycorrelated(r=0.274, p <0.01);no significant correlation between VEGF andTP (r=0.161, p=0.076).6Univariate analysis of prognosticSeeing from (table7), the3-year,5year survival rates in lymph node negativeand positive patients were69.8%/51.5%,37.1%/12.9%(χ2=26.730,P=0.000); the3-year,5year survival rates in high MVD group and low MVDgroup were56.5%/30.8%,60.0%/48.5%(χ2=10.516, P=0.001); the3-year,5year survival rates in the middle-high group of tumor cell differentiation andlow differentiation group were as follows:60.4%/40.5%,54.4%/37.9%(χ2==5.064, P=0.024); the3-year,5-year survival rates in the upper thoracic+ cervical, middle thoracic and lower thoracic were36.8%/6.1%,55.9%/39.8%,70.2%/55.2%(χ2=12.460,P=0.002); the TP-negative and positive group, the3-year,5year survival rate were65%/50.3%,51.2%/27.7%(χ2=7.239, P=0.007); TP/VEGF(+/+)group,the TP/VEGF(-/-)group and TP/VEGF (-/+or+/-)group,The3-year,5-year survival rate were50.2%/20.8%,61.1%/50.3%,61.1%/47.3%(χ2=13.906, P=0.001),log-rank test (p<0.01),the3-year5-year survival rate among lymph node metastasis group, the MVDgroup, the tumor lesion location group, a singly detection of TP and combineddetection of TP/VEGF, were significantly different with statisticalsignificance; gender,age, tumor size, histological differentiation, pathologicaltype, the depth of invasion and distant metastasis impact on the prognosis ofsurvival wad not statistically significant.7Cox multivariate analysis of prognosticThe influential factors on the prognosis of survival rate as follows:Lymphnode metastasis, pathologic type. The risk factors affecting overallsurvival of lymph node metastasis(B=1.014), pathological type(B=0.991).Conclusion:1Accompanied by lymph node metastasis,histological grade decreased, thedepth of invasion in esophageal tumor deepened, VEGF and TP positiveexpression and MVD was significantly higher. VEGF and MVD waspositively correlated;TP and VEGF was positively correlated; no significantcorrelation between VEGF and TP.2Single prognostic factor analysis showed that:The level of MVD,TP positive expression and joint detection of TP andVEGF positive expression had a significant effect on the prognosis of3-yearand5-year survival,and the joint detection of the TP and VEGF weresignificantly different,specific stronger. Obtained at the same time:The lymph node metastasis,histological grade and site of lesion also have animpaction on the prognosis.3Cox multivariate analysis of prognostic showed thatThe influential risk factors for survival were lymph node metastasis and pathologic type. Lymph node metastasis is the highest risk factors for theprognosis of esophageal cancer patients. This study also showed that there isno affect on survival in the univariate analysis, the level of MVD, positiveexpression of TP, and positive expression of combined detection of the TP andVEGF. This may be related to the small sample size of this study.