vegf在肝转移性结直肠癌中的表达与其对预后影响的临床的研究

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1、独立危险因素。结论：VEGF的表达与肿瘤分期、淋巴结转移、术前CEA水平相关，说明VEGF参与结直肠癌的发生发展，可作为病情评估的分子指标之一。VEGF在出现肝转移的阳性率明显高于未出现肝转移的患者，证明原发灶VEGF表达与结直肠癌肝转移有关。而肝转移是结直肠癌预后的独立危险因素，并且VEGF的表达能够影响结直肠癌的生存时间，提示VEGF也可能是影响结直肠癌预后独立的危险因素之一。VEGF影响辅助化疗的疗效，推测结直肠癌根治术后组织中VEGF表达阳性的人群，可考虑联合抗VEGF靶向治疗。关键词：结直肠癌转移VEG

2、F靶向治疗2ClinicalstudyontheexpressionofVEGFinlivermetastasesofcolorectalcanceranditseffectonprognosisMasterdegreecandidate：JinmingZhuSupervisor：ProfessorYangZhangVice—supervisor：JinghuaSunMajor：OncologyAbstractobjeetive：Tostudythecorrelationofvascularendothelial

3、growthfactor(VEGF)andcolorectallivermetastases(CLM)，bydetectingtheexpressionofVEGFinCLMandcorrespondingprimaryeolorectalcancertofindthesuitablepatientsofanti-VEGFtargetedthempy．Methods：Atotalof48patientsenteredthisstudy，including22caseswhodidn’tappearlivermet

4、astasesafteradjuvantchemotherapy(including5一fu4-oxaliplatinatleast4cycles)，12caseswhoappearedlivermetastasesafteradjuvantchemotllerapy，and14caseswho、析msynchronouslivermetastasesatthediagnosiswhounderwentprimaryandmetastasestissuesresection．TheexpressionofVEGF

5、wereevaluatedimmunohistochemicallyinthenormallivertissues，primaryandmetastasestissues．TherelationshipofVEGFexpressionandclinicalpathologicalfeaturesandsurvivalWasAnalyzed．Results：PositiveexpressionratesofVEGFincolorectalcancer,livermetastases，normallivertissu

6、ewas58．3％，64．2％，30．0％，nostatisticallysignificantdifferenceweredetected@>0．05)．VEGFexpressioncorrelated晰廿1tumorstage，lymphnodemetastasis，livermetastases，preoperativeCEAlevel口<0．05)，anddidn'tcorrelate埘tllgender,age，tumortypeandclassification，tumorsize，livermeta

7、stasessize(P>0．05)．In48cases，VEGF-positive·expressinpatientshadlowerDFSandOSthantheVEGFnegativeones(P<0．05)．In34caseswhoacceptedadjuvantchemotherapy，VEGF-positive-expressionpatientshadlowerDFSandOSthanVEGFnegativeones(P<0．05)．Univariateanalysisshowedthatage>6

8、0，lymphnodemetastasis，preoperativeCEApositive，IIIorIVstage，livermetastases，VEGFpositivewereprognosticfactor,However,onmultivariateanalysis，onlylivermetastasisistheindependentriskfactors．3