摘要：

AIM:To investigate the relationship between theexpression of inducible nitric oxide synthase(iNOS),vascular endothelial growth factor(VEGF),themicrovascular density(MVD)and the pathologicalfeatures and clinical staging of gastric cancer.METHODS:Immunohistochemical staining was used fordetecting the expression of iNOS and VEGF in 46resected specimens of gastric carcinoma;themonoclonal antibody against CD34 was used fordisplaying vascular endothelial cells,and MVD wasdetected by counting of CD34-positive vascularendothelial cells.RESULTS:Of 46 resected specimens of gastriccarcinoma,the rates of expressions of iNOS and VEGFwere 58.70% and 76.09%,respectively,and MVDaveraged 55.59±19.39.Judged by the standard TNMcriteria,the rate of expression of iNOS in stage Ⅳ(84.46%)was higher than those in stage Ⅰ,Ⅱ,Ⅲ(Fishexact probabilities test,P=0.019,0.023 and 0.033,respectively);the rates of expression of VEGF in stageⅢ,Ⅳ(76.0%,92.31%,respectively)were higher thanthose in stage Ⅰ,Ⅱ(Fish exact probabilities test,P=0.031,0.017,0.022 and 0.019).MVDs in stage Ⅲ,Ⅳ(64.72±14.96,67.09±18.29,respectively)werehigher than those in stage Ⅰ,Ⅱ(t=2.378,4.015,2.503and 2.450,P<0.05,P<0.001,P<0.001,P<0.05,respectively).In 37 gastric carcinoma specimens withlymph node metastasis,MVD(68.69±18.07)and therates of expression of iNOS and VEGF(70.27%,83.78%,respectively)were higher than those in the specimenswith absence of metastasis(t=2.205,x~2=6.3587,x~2=6.2584,P<0.01,P<0.05,P<0.05,respectively).MVDand the expressions of iNOS and VEGF were notcorrelated to the location,size or grade of tumor,nor withthe depth of invasion of tumor;MVDs in the positive iNOSand VEGF specimens(59.88±18.02,58.39±17.73,respectively)were higher than those in the negative iNOSand VEGF specimens(x~2=6.3587 and 6.1574,P<0.05,P<0.05,respectively);thus the expressions of iNOS andVEGF was correlated to MVD,but the expression of iNOSwas not correlated to that of VEGF.In addition,of the46 surviving patients,the 5-year survival rate ofpatients with positive iNOS or VEGF tumors wassignificantly less than that of patients with negativeINOS-or VEGF tumors(x~2=4.3842 and 5.4073,P<0.05,P<0.05,respectively). CONCLUSION:The expressions of iNOS and VEGF areclosely related to tumor angiogenesis,and are involvedin the advancement and the lymph node metastasis;thus MVD and the expressions of iNOS and VEGF mayserve indexes for evaluating staging of gastriccarcinoma and forecasting its risk of metastasis,whichwill help establish a comprehensive therapeuticalmeasure of post-operative patients and provide a newapproach to tumor therapy.

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