皮肤肿瘤组织中类高内皮微静脉的形态学研究

The study on morphology of high endothelium venule-like blood vessels in cutaneous tumor

目的:探讨人黑色素瘤组织中类高内皮微静脉与肿瘤浸润淋巴细胞(tumorinfiltratinglymphocyte,TIL)的形态特征。方法:采用光镜和透射电镜观察了10例手术切除的人皮肤黑色素瘤组织中的类高内皮微静脉和TIL的分布和超微结构。结果:类高内皮微静脉主要分布于乳头层和癌周围。病变早期其内皮高大,胞浆突起增多,核大,细胞器丰富,有大量淋巴细胞穿越管壁;病变晚期,内皮细胞核不规则,出现大量齿状切迹,细胞质内出现大量微丝和质膜小泡,线粒体多出现肿胀、扩张,基膜不连续,少见淋巴细胞穿越。TIL多存在于癌周围区,活化淋巴细胞较多。随着病程的进展,淋巴细胞数量减少。结论:1.皮肤黑色素瘤组织中部分血管可演变为类高内皮微静脉,是淋巴细胞向癌组织浸润(淋巴细胞定向归巢)的重要场所。2.肿瘤组织中的淋巴细胞归巢与抗肿瘤密切相关。

Objective： To study the uhrastructure of high endothelimn venule- like blood vessels in human melanoma. Methods：The ultrastructure of high endothelium venule-like blood vessels from ten human melanomas were observed by light microscope and transmission electron microscope. Results： In the earlier stage of melanoma, there were a lot of high endothelium venule - like htood vessels with many lymphocytes passing through the wall of them in the papillary layer and around the cancer. In this phase, the endothelium organelles had hig nucleus and inecreased in volume, with many villus projects on their surface. In the later stage of melanoma： the nucleus of the endothelium became abnonnity and appear dentate notch, with villus projects on the cell surface further increased, Lots of nficrofilanwnts and plasma membrane vesicles appeared in cytoplasm. Most mitochondria were swollen and expanded, and the basilenuna became discontinuity. The numbers of lymphoeytes passing through the wall of vessels decreased. Many tumor infiltrating lymphocytes existed around the cancer, most of them were active. With the progress of cancer, the numbers of activated lymphocytes were diminished gradually. Conclusions： Some postcapillary, venules could develop into high endothelium venule - like blood vessels in progress of cutaneous melanoma. These vessels were the important sites of lymphocyte homing, The lymphocyte homing in cancer was closely related to anticancer action.