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Significance and Expression of Microvessel Density, VEGF, VEGF Receptor-2 and Nuclear Factor-kappa B Cholangiocarcinoma

Author: ShenBo
Tutor: CaiXiuJun
School: Zhejiang University
Course: Surgery
Keywords: Cholangiocarcinoma Microvessel density Vascular endothelial growth factor Vascular endothelial growth factor receptors : nuclear factor kB Immunohistochemistry
CLC: R735.8
Type: Master's thesis
Year: 2004
Downloads: 88
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Abstract


Cholangiocarcinoma is poor prognosis of malignant tumors, 10% of the 5-year survival rate of only foreign statistics, surgical resection is currently the only effective treatment. With the advances in diagnostic imaging and surgical techniques, improved prognosis of cholangiocarcinoma, but rely solely on the improvement due to the impact of the special anatomical location cholangiocarcinoma itself infringe the blood vessels, nerves, lymph tissue and adjacent liver tissue characteristics, expectations surgery way to significantly improve the the cholangiocarcinoma therapeutic effect is not realistic. Therefore, we must better understand the occurrence of cholangiocarcinoma, development mechanism, to find new treatments. Tumor angiogenesis is one of the key events in tumorigenesis and development process. Lot of studies proved that both solid tumor growth on the basis of tumor angiogenesis, but also is an important way. Tumor angiogenesis is an uncontrolled growth of blood vessels, angiogenesis factor and inhibitory factor imbalance. Vascular endothelial growth factor (vascular endothelial growth factor, VEGF) is a most universal tumor angiogenesis stimulating factors, and by receptor binding induced receptor phosphorylation, and thus play a role. Expression was significantly increased, level with clinical stage and prognosis of breast cancer, prostate cancer and other solid tumors. Nuclear factor kB (nuclear factor-kappa B, NF-kB) is one of the most important nuclear transcription factor recently found to affect the formation of tumors, not only can regulate tumor angiogenesis related genes with cell transformation and apoptosis related. At home and abroad cholangiocarcinoma tumor angiogenesis few aspects of the research reported. In this study, by immunohistochemistry method, on the the cholangiocarcinoma patients Organization microvascular density, vascular endothelial growth factor and its receptor, and the expression of nuclear factor kB determination, combined with the clinical and pathological features and follow-up data were analyzed to explore the formation of tumor blood vessels role in the pathogenesis of cholangiocarcinoma and possible mechanisms. One kind of Zhejiang University master's degree thesis for the clinical evaluation of the degree of benign and malignant tumors, predict prognosis means to provide the theoretical basis for further study of the occurrence of cholangiocarcinoma, development mechanism, as well as looking for new treatments. Materials and Methods, Zhejiang University Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, the Second Affiliated Hospital of surgical treatment of cholangiocarcinoma n month period from October 1997 to 2003 50 patients. Six cases including 31 cases of hilar cholangiocarcinoma middle cholangiocarcinoma, 13 cases under paragraph cholangiocarcinoma. The patients, 27 males and 23 female, aged from 32 a 84-year-old, with an average age of 59.3 years old. Surgery: radical resection in 27 cases, 23 cases of palliative resection. All specimens were confirmed by pathology, including 19 cases of well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma, 21 cases, 10 cases of poorly differentiated adenocarcinoma; 13 cases with lymph node metastasis; with neural invasion 22 cases; 14 cases associated with pancreatic infiltration . Control taken from nine cases of liver transplant donor. Experimental groups: nine cases the bile ducts of the liver transplant donor specimens as normal tissue; cutting edge of cancer tissue taken from 27 patients with radical resection specimens; tumor surgical specimens taken from 50 patients with cholangiocarcinoma. Follow-up: by telephone survey, the petition survey, combined with outpatient follow-up of 27 patients who underwent radical surgical treatment of patients with cholangiocarcinoma since the day of surgery until March 20, 2004 whether survival, survival time and the cause of death. By immunohistochemical staining En Vi 510. The footwork detect microvascular density (MVD), vEGFI. The:, vEGFR the 2 the Flk l / KDR), NF a kBp65 expression. Results to determine: 1 and CD34 positive judgment and the MVD determination of vascular endothelial cells were stained brown background apparent Any stained endothelial cells or cell populations as a blood vessel. First at low magnification (10 x 10) to find the highest vascular density (hotspot), and then counted at high magnification (10X40) the five vascular highest density area of ??the microvessel counts, averaging representative MVD. Of VEGF165 in Flk a 1/KDR and - the NF a kBp65 positive results judgment, positive expression of cytoplasmic stained brown, high magnification (10 X40) take five different horizons count of 100 cells per field, the percentage of positive cells and staining intensity were scored. Specific scoring criteria are as follows: (1) the percentage of positive cells lt; sryoo points, 5% 25ryol points, 26% to 50% 2 75% 3, slok, gt; 75% 4. (2) positive cells staining intensity for dyeing O points, dyed light brown 1 minute 2 minutes, stained brown, dyed dark brown or dark brown plaque cytoplasm. (1) (2) for the organization of the total score, the score is divided into the O 7 points. O is divided into negative, 1 to 3 is divided into weakly positive (), Zhejiang University master's degree thesis divided into strongly positive (4-7). The percentage of positive cells universal medical image processing system. All data processing are using SPSS n.0 for windows software package for statistical analysis. Quantitative data using analysis of variance, chi-square test of qualitative data, survival data the Ka port an Meier survival analysis. Results and discussion MVD in the cholangiocarcinoma and paracancerous organizations level higher than that in normal tissues (P lt; 0.01). MVD level and the patient's age, sex and tumor location and histological type were not correlated (P gt; 0.05). The organization Na D levels associated with lymph node metastasis than those without lymph node metastasis group, with perineural invasion tissue Na D levels than those without perineural invasion group, and the differences were statistically significant (to 0.05). Follow-up of patients with radical surgery, MVD lt; 30 patients with an average survival time of 26.83 months, MVD of 30 to 39 with an average survival time of 13.83, just D), 40 patients with a mean survival time of 5.75 months survival rates among the three groups the difference was statistically significant (p lt; 0.05). These results suggest that angiogenesis has an important significance in the incidence of cholangiocarcinoma. Previous studies have confirmed lymph node metastasis and perineural invasion prompted prognosis of two independent factors, combined with the postoperative follow-up, we believe that tumor angiogenesis and prognosis related to the high level of MVD indicates a poor prognosis. VEGF: 65 next to the tumor tissue and cancer tissues than in normal tissues, VEGFR 2 (Flk 1/KDR) in tumor tissue cancer and adjacent tissues levels are higher than normal tissue, the differences were statistically significance (P lt; 0 .05). At the same time of VEGF, 6,, and Flk a 1/KDR with just D levels showed a positive phase?

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