中文摘要：

目的探讨血管内皮生长因子（vascular epithelial growth factor,VEGF）在胆囊癌血管生成拟态（vasculo-genic mimicry,VM）组织中的表达及其意义。方法收集74例原发性胆囊癌、10例胆囊腺瘤和10例慢性胆囊炎石蜡标本及相关临床病理资料,应用免疫组化Envison法、Kaplan-Meier生存比较和Cox风险模型分析VEGF与胆囊癌VM的相关性和临床意义。结果VM（-）胆囊癌VEGF表达明显高于VM（＋）胆囊癌（P=0.018 2）;VM（＋）胆囊癌肝转移组VEGF表达显著高于无肝转移组（P=0.032 3）;Nevin S3-S5期,VM（＋）胆囊癌VEGF表达明显低于VM（-）胆囊癌组（P=0.049 0）;VEGF阳性表达组,VM（-）胆囊癌患者术后5年生存期明显长于VM（＋）组（P=0.007 2）,VM是影响胆囊癌患者预后的独立因素。结论VEGF表达差异与胆囊癌VM相关,VEGF是判断VM阳性胆囊癌肝脏转移的指标,与VM同作为预判胆囊癌预后的重要参考指标。

英文摘要：

Objective To evaluate the expression of vascular epithelial growth factor （VEGF） in human primary gallbladder carcinomas with vasculogenic mimicry （VM） and its significance, Methods Seventy-four primary carcinomas, 10 adenomas and 10 chronic inflammatory lesions of the gallbladder underwent operations and were confirmed histopathologicaUy and their clinical-pathological data were studied and followed-up, Envision method of immunohistochemistry was used to determine the expressions of VEGF gene proteins in each paraffin section of every patient in vivo. The correlation between VEGF expression and VM and their clinical significance in gallbladder carcinomas were analyzed and compared by Kaplan-Meier actuarial survival curves and Cox multiple factor analysis. Results VEGF expressions in gallbladder carcinomas without VM increased more significantly than that with VM （P = 0. 018 2）. In gallbladder carcinomas with VM, expressions of VEGF with liver metastasis increased significantly than those without metastasis （ P = 0. 032 3 ）. In the Nevin stage （ S3 - S5 ）expressions of VEGF were higher significantly in gallbladder carcinomas without VM than those with VM （P = 0. 049 0）. That patients with positive expression of VEGF in non-VM group underwent operation had longer 5-year survival than in VM group （P = 0. 007 2）. Cox multiple factor analysis showed that VM was an independent risk factor for the prognosis of primary gallbladder cardnoma. Conclusion The differences of VEGF expression related to VM in human gallbladder carcinomas. VEGF is an important clinical index for evaluation of liver metastasis in gallbladder carcinoma patients with VM. Both VEGF and VM are valuable markers to estimate prognosis in patients with gallbladder carcinoma.