文档介绍：胃癌癌周微淋巴管与淋巴道转移的关系及其意义
【摘要】目的探讨胃癌癌周微淋巴管与淋巴道转移的关系及其与临床病理特征之间的关系。方法采用微淋巴管特异标记物Podoplanin标记微淋巴管,用Ki67检测微淋巴管内皮细胞的增殖活性,在一张切片上同时测定56例胃癌组织微淋巴管密度及其增殖活性,并结合胃癌临床病理特征进行分析。结果胃癌癌周微淋巴管密度与肿瘤的分化程度、淋巴结转移以及淋巴管受累有关(F=,t=、;P<、)。胃癌癌周微淋巴管内皮细胞Ki67指数仅与淋巴管受累有关系(t=,P<)。结论胃癌癌周微淋巴管可能促进肿瘤淋巴道转移;胃癌癌周微淋巴管密度是评价其分化程度、淋巴结转移及淋巴管受累的有价值的指标。
【关键词】胃肿瘤淋巴转移淋巴管生成肾小球足突细胞膜黏蛋白
[ABSTRACT] Objective To investigate the relationship between surrounding microlymph vessels and lymphatic metastasis in gastric carcinoma. Methods The lymphatic micro vessel density (LMVD) in cancersurrounding area was detected in 56 cases and evaluated by immunohistochemistry, using monoclonal antibody for Podoplanin. The Ki67 expression of the lymphatic lining cells was detected at the same time by doublelabeling immunohistochemistry. The relationship between LMVD and clinic pathologic features was analyzed. Results The LMVD in cancer
surrounding area was significantly correlated with differentiation, lymphatic involvement, and lymph node metastasis (F=;t=,;P<,). The Ki67 labeling index of the lymphatic lining cells correlated only with that with lymphatic involvement (t=,P<). Conclusion The microlymphatic vessels may promote lymphatic metastasis, their density is of value in assessing the differentiation, lymph node metastasis and lymphatic involvement of the cancer.
[KEY WORDS] Stomach neoplasms; Lymphatic metastasis; Lymphangiogenesis; Podoplanin
淋巴道转移是胃癌最常见和最重要的转移途径,也是影响病人生存的重要因素之一。长期以来,由于缺乏淋巴管特异性标记物,对肿瘤淋巴道转移的研究一直较为薄弱。新近研究表明,许多恶性肿瘤存在新生淋巴管,并与淋巴道播散与转移密切相关。胃癌局部淋巴结转移十分常见,其癌周微淋巴管与肿瘤淋巴道转移之间的关系和临床病理意义目前仍不清楚。Podoplanin是继VEGFR3后发现的又一特异性淋巴管内皮细胞标记物,且其特异性较VEGFR3更强[1]。本文采用Podoplanin标记胃癌组织的微淋巴管,同时用Ki67显示微淋巴管内皮细胞的增殖状态,即通过免疫组织化学双重标记法,在一张切片上同时显示微淋巴管及处于增殖状态的微淋巴管内皮细胞,结合临床病理资料进行综合分析,探讨胃癌癌周微淋巴管与淋巴道转移的关系及其临床病理意义。
1 资料与方法
一般资料
选取青岛大学医学院附属医院病理科2005年1~12月手术切除的胃癌存档蜡块56例,胃癌蜡块均包含取自于癌中央区(即癌内)癌组织和周围正常组织交界区(即癌周)的组织,所有病人手术前未接受过化疗和放疗。56例病人中男31例,女25例,年龄42