침윤성 자궁경부암에서 혈관내피세포 성장인자의 발현과 혈관신생
VEGF (Vascular Endothelial Growth Factor) Expression and Angiogenesis in Invasive Cervical Cancer
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목적: 악성종양에서 VEGF가 종양성장과 신생혈관 형성을 통하여 종양화에 관여하는 것으로 알려져 있다. 이에 저자들은 침윤성 자궁경부암 조직에서 VEGF의 발현과 미세혈관밀도를 조사하여 VEGF가 자궁경부암의 성장에 미치는 영향과 임상적 관련성에 대하여 조사하고자 했다. 연구 방법: 1999년 2월 1일부터 2001년 7월 31일까지 한림대학교 산부인과에서 침윤성 자궁경부암으로 진단 받은 환자 중, 외과적으로 절제된 20명을 대상으로 하였다. 적출된 자궁 또는 생검된 조직으로부터 자궁경부암 조직의 절편을 만들고, VEGF항체와 CD31항체를 이용하여 혈관들을 면역조직학적으로 염색하였다. 그리고, 이 결과들과 환자들의 임상적 예후인자들과 통계학적 분석을 시행하였다. 결과: 모든 환자들의 조직에서 VEGF의 면역반응은 양성을 나타내었고, 미세혈관밀도는 강양성을 나타내는 조직에서 더 높았으며, 통계적으로 미세혈관밀도는 VEGF와 의미있게 관련있었다. 또한, 여러 임상인자들 중, parametrium 침범이 있었던 조직에서 VEGF 면역반응정도가 통계적으로 유의하게 높은 것이 증명되었다. 결론: VEGF가 자궁경부암의 혈관신생 과정에 중요한 역할을 하며, 예후와 관련가능성이 있음을 알 수 있었다.
Abstract
Objective: A large body of evidence suggests that vascular endothelial growth factor (VEGF) is important to tumor growth and angiogenesis in cancers. This study was designed to determine the relationship between tumor vascularity and VEGF expression in invasive cervical cancer. Furthermore, we also compared the clinical factors with VEGF expression. Methods: We examined the expression of VEGF and microvessel density (MVD) by immunohistochemical staining in 20 specimens collected from invasive cervical cancer patients. Thereafter, we compared the results with several clinical factors. We used the Chi-square test and One way Anova test for statistical analysis. Results: All specimens showed weak and strong immunoreactivity. Microvessel counts were high in the strong (median 157.6) VEGF immunoreactivity and low in the weak (median 90) VEGF immunoreactivity (P=0.000). In addition, parametrium invasion showed statistically significant correlation with VEGF expression extent (p=0.021) but age, SCC, CEA, lymphovascular invasion, lymph node invasion and invasion depth of cervix showed no correlation. Conclusion: The overexpression of VEGF may play an important role in the promotion of angiogenesis in cervical cancer and may have relation to prognosis.
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