The Clinical Significance And Connection Of CAFs Density And Lymph Vessel Density,Microvessel Density Expression In Lung Squamous Carcinoma

Objective To explore the expression of FAP-1 with the cancer associated fibroblasts(CAFs),microvessel density(MVD),lymphatic vessel density(LVD)in lung squamous carcinoma and the clinical significance.Methods 63 patients with lung squamous cell carcinoma,who received resection with curative intent at the Department of Thoracic Surgery of the Qingdao Municipal Hospital from 1 January,2011 to 31 December,2012,were chosen from the database of the Qingdao Municipal Hospital.The 63 blocks available were cut into 4-um-thick sections.They were stained with FAP-1 polyclonal antibody(1:100,Biosynthesis,Beijing)for histopathological evaluation of CAFs.Lymphatic vessels were stained with D2-40 monoclonal antibody(1:50,Zhongshanjinqiao,Beijing)and microvessels were assessed by CD34 staining(monoclonal antibody 1:100,Maixin,Shanghai).FAP-1 staining was assessed by the intensity in percentage of positive cells in the intraepithelial stromal compartment and scored as previously established: Grade 0,absent or < 1% staining in stroma;Grade 1,1–10% positive staining;Grade 2;11–50% positivity;Grade 3 > 50%positive staining.High expression was defined as a grade > 3(FAP-1 positivity > 50%).Only vessels showing typical lumen morphology were considered lymphatic vessels.The same as microvessel density.Follow-up was carried out until December 2015 or death of patients.All patients had a regular follow-up schedule including a complete history and physical and radiological examination over the course of the follow-up period.Patients who died for non-cancer-related reasons were excluded.Statistical package SPSS version17.0 was used for data analyses.The Pearson's chi-squared test was carried out to compare the correlation between CAFs density and increased LVD or MVD in lung squamous cell carcinoma.The Chi-square test was also used to analyze clinical pathological factors.The Cox proportional hazards model was used to determine the hazard ratio of variables on 3-year overall survival.All P values were calculated based on two-tailed statistical analyses and a P-value < 0.05 was considered statistically significant.Results In all tumors,CAFs was stained by FAP-1 successfully.Assessed by two independent researchers,36 cases were CAF-poor and 27 were CAF-rich.The expression of FAP-1 was related to cell differentiatio and lymphatic metastasis(P?0.05).The LVD with high CAFs expression was clearly higher than those with lower CAFs expression,so was MVD(P ? 0.05).In the Cox model,CAFs density,lymph node status were significantly related to 3-year overall survival(P?0.05).Conclusion The research demonstrated that CAFs density correlated mainly to the increase of LVD and MVD,and was associated with poor prognosis of patients with lung squamous carcinoma.