胰腺导管腺癌血管及导管的弹力纤维改变及其临床病理意义

Elastic changes of vessels and ducts in ductal adenocarcinoma of the pancreas and their clinicopathological significance

目的通过对胰腺导管腺癌(PDAC)中血管和导管弹力纤维的分布及分级进行观察和分析,评价其在PDAC诊断中的价值。方法对36例PDAC的石蜡包埋标本进行弹力纤维染色,观察不同组织内血管、导管,癌组织内腺体及间质的染色情况,计算不同组织内所有观察到的血管和导管的评分之和。结果36例PDAC标本中,癌组织内血管及导管周围均可见中度至重度弹力纤维增生,癌旁组织中的血管及导管周围弹力纤维轻度增生,正常组织内血管及导管周围无弹力纤维增生。癌组织内血管和导管周围弹力纤维增生程度明显高于癌旁组织及正常组织,差异有统计学意义(P<0.05)。值得注意的是,癌组织内腺体周围及间质内没有观察到弹力纤维增生。结论癌组织内血管及导管周围弹力纤维增生的程度明显高于癌旁及正常组织,这一现象可以通过弹力纤维染色得以较好地呈现,对于胰腺导管腺癌的诊断,弹力纤维染色能够提供一定的帮助。

Objective To observe and analyze the distribution and classification of vascular and ductal elastic fibers in pancreatic ductal adenocarcinoma(PDAC),and to evaluate their value in the diagnosis of PDAC.Methods Thirty-six cases of PDAC were stained with elastic fibers.The staining of blood vessels and ducts in different tissues,glands and stroma in cancer tissues were observed,and the scores of all vessels and ducts in different tissues were calculated.Results In 36 PDAC samples,moderate to severe elastic fiber hyperplasia was observed in the blood vessels and around the ducts in cancer tissue,mild elastic fiber hyperplasia in the blood vessels and around the ducts in the paracancer tissue,and no elastic fiber hyperplasia in the blood vessels and around the ducts in normal tissue.The hyperplasia of vascular and periductal elastic fibers in cancer tissues was significantly higher than that in para-cancer tissues and normal tissues,and the difference was statistically significant(P<0.05).No elastic fiber hyperplasia was observed around the glands and in the interstitium in the cancer tissue.Conclusion The degree of elastic fiber hyperplasia in the vascular and periductal tissues of carcinoma is significantly higher than that in the peripheral and normal tissues,and this phenomenon can be better demonstrated by elastic fiber staining,which can provide certain help for the diagnosis of pancreatic ductal adenocarcinoma.