| Objective: Neovascularization within the tumor was achieved through angiogenesis and essential for tumor growth and extension,its play an important role in growth,invasion and metastasis of tumor. Many studies indicate that the degree of tumor angiogenesis activity are closely related to pathological grade,moreover,its has significant vaule both in evaluate on radiotherapy and the prognosis. Among in the many known angiogenesis factors,vascular endothelial growth factor(VEGF) is a mitogen for endothelial cells and a potent angiogenesis-promoting factor,and its though to be a major tumor angiogenesis regulator. This experiment studies the expression of vascular endothelial growth factor (VEGF) in serum and lesion tissue of esophageal squamous cell carcinoma patients and the microvascular distribution in tumor lesions, investigate the roles of the vascular endothelial growth factor (VEGF) in high-risk screening patients and its prognostic value for esophageal squamous cell carcinoma patients.Methods: Expression of VEGF in serum of 46 patients with esophageal squamous cell carcinoma and 10 healthy people were detected by ELISA. Immunohistochemistry methods(Elivison 2- step) were used to examine VEGF/CD34 expression in 46 tumor tissues and VEGF expression in 15 normal esophageal tissue .Results: (1)The serum VEGF level of 502.176±65.218 pg·ml﹣1 in patients with esophageal squamous cell carcinoma was significantly higher than that of 311.648±40.984 pg·ml﹣1 in control group. (p<0.01)(2)The serum levels of VEGF in patients infiltrating mucous membrane , muscular layer, adventitia, and adjacent tissue were 434.725±49.703 pg·ml﹣1,503.504±68.500 pg·ml﹣1,595.441±48.192 pg·ml﹣1respectively .There was significant difference among three vertical infiltration extent in esophageal squamous cell carcinoma(p<0.01). Compared to patients without lymph node metastases, the serum level of VEGF increased significantly in patients with lymph node metastases. The serum VEGF level of 580.012±56.996 pg·ml﹣1 in patients withⅢstage was singnificantly higher than that of 446.890±50.602 pg·ml﹣1 inⅠand Ⅱstage(p<0.01).(3)The pathological tissues levels of VEGF in patients infiltrating mucous membrane , muscular layer, adventitia, and adjacent tissue were 0.374±0.0396,0.549±0.0372,0.654±0.0395 respectively .There was significant difference among three vertical infiltration extent in esophageal squamous cell carcinoma(p<0.01). Compared to patients without lymph node metastases, the pathological tissues level of VEGF increased significantly in patients with lymph node metastases. The pathological tissues VEGF level of 0.629±0.0545 in patients withⅢstage was singnificantly higher than that of 0.439±0.0856 inⅠandⅡstage(p<0.01).(4)VEGF mainly expressed in cancer cell endochylema, and was more remarkble on the edge of the cancer nest. VEGF showed positive expression in esophageal muscular layer and partial vascular endothelial cell. However, the stain in esophageal muscular layer and partial vascular endothelial cell was lighter than that in cancer cell. The positive expression of VEGF in necrotic tumor was obvious, showing asystematic distribution. And the stain was deeper than the cancer cell endochylema.(5)There was almost no expression of VEGF in normal tissue.(6)Microvascular signed by CD34 were observed in the invading front but also in normal esophageal tissue and inner tumor areas. There were no regularity of there distribution.We search for the hot spots further more,the vessels were observed mainly in the edge of the cancer nest compared with inner tunmer areas, neovascularization within the tumor has irregular lumen and imperfect structure, tumor cells outside the blood vessels can be directly connected with the lumen.Conclusion: Vascular endothelial growth factor(VEGF) is overexpressed in pathological tissues and serum of patients with esophageal squamous cell carcinoma. VEGF expression is remarkably related to vertical infiltration, lymph node metastases and TNM stage. VEGF expression can reflect the progress of the disease to a certain extent,and there is consistency betweenVEGF expression in esophageal squamous cell carcinoma lesions and serum VEGF level. Serum VEGF monitoring is valuable for clinical decision making and prognosis,and a potential criterion for high risk patient sreening in esophageal squamous cell carcinoma. |
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