摘要 目的 探讨CD34和血管内皮生长因子（VEGF）在人成釉细胞瘤（Ameloblastoma, AB）及牙源性角化囊肿（Odontogenic keratocyst, OKC）中的表达及微血管密度（MVD）的病理生物学意义。方法 对78例AB（原发36例，复发35例，恶变7例，其中1例为淋巴结转移，3例肺转移）。18例OKC，4例正常粘膜上皮组织，进行了CD 34免疫组织化学SP法检测，在70例AB、33例OKC、7例正常口腔粘膜进行VEGF抗体检测。对CD34阳性血管进行MVD计数，对VEGF行半定量计数，结合病例病理特征进行分析。结果 在AB中CD34呈广泛阳性表达，血管分布有三种形式，恶性AB多为以血管为中心肿瘤细胞呈袖套状围绕其周围或在侵袭性瘤细胞周缘血管呈串珠状排列，良性AB血管多为弥漫散在或在侵袭性肿瘤周边呈簇状排列。血管数量与细胞分化有关，角化退变细胞周常缺乏血管。在AB原发、复发、恶变的不同病变中MVD逐渐增加，（P<0.001）。AB分别与OKC，正常粘膜MVD明显不同，（P<0.001）。VEGF的表达与MVD呈正相关且表达规律与MVD一致。结论 肿瘤血管的形成与AB、OKC细胞分化及临床病理的生物学行为密切相关。
关键词 成釉细胞瘤；牙源性角化囊肿；内皮生长因子；抗原CD34

Expression of CD34 and VEGF in Human
Ameloblastoma and Odontogenic Keratocyst
Zhong Ming , Wang Jie. Department of Pathology, College of Stomatology, China Medical
University. Shenyang, Liaoning, 110002, P. R. China
[Abstract] Objedctive: To study the expression of CD34 and vascular endothelial growth
factor (VEGF) in Human ameloblastoma (AB) and odontogenic keratocyst (OKC).
Methods: Specimens of 78 cases of AB (including primary AB 36 cases, recurrent AB 35
cases, malignant AB 7 cases), 18 cases of OKC, 4 cases of oral normal mucosa were
examined by streptovidin-biotin method using anti-CD34 monoclonal antibodies, and
expression of VEGF was detected in 70 cases of AB, 33 cases of OKC and 7 cases of oral
normal mucosa by immunohistochemistry. MVD was counted for CD34 positive vessels.
Results: CD34 was extensive positive expressed in AB. In malignant AB, vessels appeared
in catenuliform around invasive tumor cells or were sleeved by tumor cells. In benign AB,
vessels were extensive scattered or appeared in cluster around invasive tumor cell.
Immunoreactivy for CD34 suggested that vascular number was related with cell
differentiation, and vessels were rarely found around keratotic and degraded cells. MVD
increased gradually in primary, recurrent and malignant AB (P<0.001). Comparing AB with
OKC and normal oral mucosa, there was a great difference in MVD (P<0.001). VEGF
expression was significantly associated with MVD with the same expression pattern.
Conclusions: Tumor vascular number is related to cell differentiation and tumor
biological characteristics in AB and OKC.

Key Words: Ameloblastoma; Odontogenic keratocyst; Endothelial growth factors; CD34
AB及OKC的发生及浸润性生长，术后复发的生物学行为一直为口腔外科及病理医师所关注的热点。血管生成在肿瘤的生长和转移中起着重要作用，目前对肺癌、肝癌、骨肉瘤、口腔鳞癌等(1-4)多种肿瘤研究表明，肿瘤血管生成与肿瘤的病理进展和预后不良密切相关。CD34为血管内皮细胞的特异性标记物，优于V Ⅲ因子抗体及荆豆凝集素。AB及OKC与CD34的关系不甚清楚，故我们用抗CD34单克隆抗体显示血管内皮细胞，探测人AB及OKC中CD34和血管内皮生长因子（VEGF）的表达以及微血管密度（MVD），并与正常口腔粘膜作对照。

责任编辑：姚红祥