淋巴管内皮透明质酸受体-1标记的喉鳞状细胞癌组织淋巴管密度测定及其临床意义

Clinical significance of lymph vessel density marked by lymphatic ressel endothelial hyaluronic acid receptor-1 in laryngeal squamous cell carcinomas

目的:探讨喉鳞状细胞癌组织中微淋巴管密度、位置及增殖情况与喉癌生物学行为和临床病理因素的关系。方法:利用LSAB免疫组化三步法研究淋巴管内皮特异性标记物淋巴管内皮透明质酸受体-1(LYVE-1)在喉鳞状细胞癌组织中的表达,光镜和图像分析观察微淋巴管密度并对淋巴管进行定位;EnVision免疫组化二步法研究Ki67在LYVE-1(+)管腔的表达,评价淋巴管增殖情况。结果:①颈淋巴结转移组瘤巢内LYVE-1(+)管腔密度高于非转移组,差异有统计学意义(P<0.01);T1组瘤巢内LYVE-1(+)管腔密度低于T2、T3、T4组,差异具有统计学意义(均P<0.01),T2组瘤巢内LYVE-1(+)管腔密度低于T3、T4组,差异有统计学意义(均P<0.05),T3组与T4组瘤巢内LYVE-1(+)管腔密度相比差异无统计学意义(P=0.582);瘤巢内LYVE-1(+)管腔密度在声门型组与声门上型组、鳞癌Ⅰ级组与鳞癌Ⅱ级组之间差异无统计学意义(均P>0.05)。②颈淋巴结转移组瘤巢周LYVE-1(+)管腔密度高于非转移组,差异无统计学意义(P>0.05)。③瘤巢内LYVE-1(+)管腔存在Ki67核棕黄色着色,瘤巢周LYVE-1(+)管腔未见这一现象。结论:喉鳞状细胞癌组织LYVE-1标记的瘤巢内淋巴管密度与肿瘤浸润、淋巴结转移正相关;喉鳞状细胞癌肿瘤淋巴管生成主要在瘤巢内,瘤巢内淋巴管在肿瘤的浸润、转移过程中发挥更为重要的作用。

Objective：To study the relationship between density, location, proliferation of lymph vessels and clinicopathological features of laryngeal squamous carcinoma. Method： Tumor lymph vessels were quantitated and located in archival specimens of laryngeal carcinoma by LSAB immunostaining for the recently described lymphatic endothelial marker LYVE-1. The Ki67 proliferation marker was used to evaluate the proliferating conditions of LYVE-1 （＋）vessels with EnVision immunohistochemical methods. Result ： ①The density of intratumoral LYVE-1 （ ＋ ） vessels was higher in the cases of neck lymph nodal metastasis group than that of no neck lymph nodal metastasis group（ P =0. 000）. There was a significant difference of the density of intratumoral LYVE-1（＋ ）vessels in the cases of T1 ,T2 and T3-4 group. There was no significant difference of the density of intratumoral LYVE-1 （ ＋ ） vessels between supraglottic group and glottic group,squamous cell histological types Ⅰ group and types Ⅱ group （ P = 0.125,0. 146, respectivly）. ②The density of peritumoral LYVE-1 （＋）vessels was higher in the cases of neck lymph nodal metastasis group than that of no neck lymph nodal metastasis group. However, there was no statistic significance（ P = 0. 253）. ③Ki67 （ ＋ ） immunostaining occurs in some of the intratumoral LYVE-1 （ ＋ ） vessels, interestingly,there was no this phenomenon in the peritumoral LYVE-1 （＋）vessels. Conclusion： Intratumoral lymph vessel density marked by LYVE-1 in laryngeal carcinoma was significantly correlated with tumor infiltration and metastasis. Our results provide potent evidence that proliferating lymphatics exists in intratumoral areas of laryngeal carcinoma mainly which maybe contribute to lymph node metastasis in some cases.