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A Preliminary Study of Vasculogenic Mimicry in Gastric Cancer

Author: YangZuo
Tutor: ZhangJianWen
School: Nanhua University
Course: General Surgery
Keywords: vasculogenic mimicry gastric cancer prognosis molecular mechanism
CLC: R735.2
Type: Master's thesis
Year: 2011
Downloads: 67
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Abstract


Objective:1、To study whether the existence of vasculogenic mimicry(VM)is in gastric cancer ;2、To evaluate the significance of vasculogenic mimicry and patient-related clinical pathology indicators and the relationship between vasculogenic mimicry and patient prognosis;3、To explain initially the formation of the molecular mechanism of vasculogenic mimicry.Materials and Methods: 1. Using a retrospective study method, a total of 149 patients with gastric cancer was collected from January 2005 to December 2005 at the South China University Affiliated First People’s Hospital of Chenzhou City. After surgical excision, formalin-fixed, paraffin-embedded gastric cancer, relevant clinical pathology material and follow-up data of 84 cases was collected.By assessing HE stained,applying CD31/PAS double staining and combined with CD105 and CD31 immunohistochemistry staining ,whether VM was exist in gastric cancer was observed and incidence of VM was analyzed in gastric cancer;Clinical pathologic index signigicance and patient prognosis were compared between the VM positive group and the VM negative group. 2.By collected 84 cases of specimens and clinical pathology material of gastric cancer, Mattern integration method,microvessel density (Microvessel density, MVD) count, the density of vasculogenic mimicry density (Vasculogenic mimicry density, VMD) of these samples were evaluated.The expression of MMP-2, MMP- 9, EPHA2, VE-cadherin and VEGF in gastric cancer were analyzed,whose difference of MVD and VMD were evaluated between the positive and the negative groups.The difference and correlation of VM positive and negative groups and in protein’s expression were statistically investigated.Result: 1. By CD31/PAS double staining VM structure were confirmed the existence in gastric cancer. VM structure was observed in 21 of the 84 gastic cancer,the positive was 25.0%.2.The tumor diameter ,TNM stage,grade and hematogenous metastasis were related to VM-positve rate;In the VM group,the rate of hematogenous metastasis was higher 42.85%(9/21) than that of non-VM gtoup17.46%(11/63) (p<0.05).3.The overall survival of the VM-positive patients[(33.57±3.80) months] was shorter than that of the VM-negative[(49.80±1.93) months] in the univariate analysis significantly(p<0.05).4.Multivariate analysis showed that VM, TNM stage,grade, hematogenous metastasis,lymph node metastasis of gastic cancer ia an independent prognostic impact of risk factors of patients (p<0.05).5. In gastric cancer, the expression of MMP-2, EPHA2, VE-cadherin was higher in VM positive group than the negative group.But the expression of VEGF was significantly lower than VM negative group (p<0.05);The VMD was higher in the positive groups of MMP-2, EPHA2, VE-cadherin than the negative.However, the VMD of VEGF was reversed (p<0.05); The MVD was higher in the positive groups of MMP-2, MMP-9, EPHA2, VEGF than the negative(p<0.05).It was positively correlated between MMP-2, EPHA2 and VE-cadherin in VM positive group(r=0.567;r=0.596;r=0.460).Conclusion: 1. VM has turned out to found also exist in gastric cancer.VM is tumor cells adapted for the microenvironment and produce a unique functional blood mode.2. Expression of VM in gastric cancer correlates with the grade of gastric cancer.The higher is malignant degree,the more probability VM appeared in gastric cancer.3. VM positive gastric cancer patients is prone to hematogenous metastasis,it is worse than VM negative in clinical prognosis and survival time is short.VM can be used as one of the indicator to judge the prognosis of patients with gastric cancer.4. It is positively correlated between MMP-2, EPHA2 and VE-cadherin in gastric cancer of VM positive group. It is possible to participate in the formation of tube-like structure that carries blood:that is VM.5. In gastric caner angiogenesis, MMP-2, MMP-9,EPHA2,VEGF plays an important regulatory role.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Gastric neoplasms
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