RESUMO
Objective To explore the influence and clinical significance of chemotherapy on the expressions of micro-vessel density (MVD) and vascular endothelial growth factor (VEGF) in pediatric difficult removal solid tumor.Methods From Jan.2002 to Jan.2012,totally 80 cases of the hospitalized pediatric patients with solid tumor (Ⅲ b-Ⅳb stage) were enrolled in this study in Department of Pediatric Surgery of the Second Hospital of Hebei Medical University.All of the tumors were identified as difficult removal malignant tumor by imageology and physical examinations.After biopsy of the tumors,these patients were divided into neuroblastoma group (25 cases),hepatoblastoma group (25cases) and Wilms' tumor group (30 cases).All patients in these 3 groups underwent chemotherapy respectively according to their different pathologic findings,thereafter,the tumor resections were performed.The resection rates of tumor in each groups were recorded and the expressions of MVD and VEGF between preoperative biopsy and postoperative specimens were detected and compared by immunohistochemistry in different groups.Results With chemotherapy,the resection rate of neuroblastoma was 80.00％ (20/25 cases),hepatoblastoma was 92.00％ (23/25 cases) and Wilms' tumor was 96.67％ (29/30 cases).There was no significant difference among them (x2 =4.286,P =0.117).Before chemotherapy,the positive expressions of VEGF in neuroblastoma,hepatoblastoma and Wilms' tumor were 80.00％ (20/25 cases),90.00％ (18/20 cases) and 83.33％ (25/30 cases) respectively,at the same time,the values of MVD were 48.39 ± 15.87,52.16 ± 16.12 and 46.82 ± 19.07.After chemotherapy,the expressions of VEGF and MVD in neuroblastoma,hepatoblastoma and Wilms' tumor were 52.00％ (13/25 cases),45.00％ (9/20 cases),30.00％ (9/30 cases) and 31.31 ± 14.21,25.19 ± 15.31 and 29.06 ± 13.05.Compared with the expressions of them in each group before chemotherapy,significant differences were found (all P ＜ 0.05).Conclusions Chemotherapy can efficiently promote the resection rate for pediatric difficult removal solid tumor.MVD and VEGF can be considered as the markers in evaluating the outcomes of chemotherapy and promoting the resection rate of tumors.