胃癌微淋巴管的增殖状态及分布特点

OBSERVATION OF DISTRIBUTION FEATURES AND PROLIFERATION OF LYMPHATIC VESSELS IN GASTRIC CANCER

目的探讨胃癌微淋巴管的分布特点以及增殖状态。方法应用双重免疫组织化学染色的方法,采用Podoplanin及Ki-67标记56例胃癌及12例相应正常胃组织,并检测微淋巴管及微淋巴管内皮细胞的增殖活性。结果正常胃组织微淋巴管在黏膜固有层、黏膜下层、肌层及浆膜层均可见到,且在黏膜下层数目最多,多呈扩张状,壁薄,形态大小不一,其微淋巴管密度(LMVD)为6.93±1.32。胃癌微淋巴管在癌周及癌内数目及形态均不同,癌内微淋巴管数目少,其LMVD为5.83±3.26,并且多闭锁呈条索状;癌周微淋巴管数目多,其LMVD为11.89±3.95,且扩张呈管腔样,有时可在其中发现癌栓。癌周LMVD与癌内比较,差别有高度统计学意义(t=10.1,P<0.01);与相应正常胃组织比较,差别亦有统计学意义(t′=7.52,P<0.05)。胃癌癌周微淋巴管内皮细胞Ki-67指数与癌内微淋巴管及相应正常胃组织微淋巴管相比较,差别均有统计学意义(t=6.38、6.88,P<0.05)。结论胃癌组织中存在新生微淋巴管,癌周数目较多,且具有较高增殖活性,提示癌周微淋巴管可能是发生淋巴结转移的主要功能性淋巴管。

Objective To investigate the distribution pattern and proliferation of lymphatic vessels in gastric cancer. Methods Using monoelonal antibody against podoplanin, lymphatic vessel density （LMVD） in tissues of 56 cases of gastric cancer and of 12 cases of normal stomach was studied. Lymphatic endothelium was displayed by double immunohistoehemieal-labeling using Ki 67. Results Lymphatic vessels were easily found in the whole wall of normal stomach with LMVD 6.93± 1.32, while lymphatic vessels in cancerous tissues were fewer （LMVD 5.83 ±3.26） with narrower lumens, lymphatic vessels in perieaneerous tissues more than those of normal tissues （LMVD 11.89±3.95） with dilated lumens. The differences in LMVDs among different tissue samples were significant （P〈0.01）. The Ki-67 labeling index of the lymphatic endothelium was found significantly higher in perieancerous tissues than that of normal gastric submueosa and in cancerous tissues （t=6.38,6.88;P〈0.05）. Conclusion In pericancerous tissues, newly formed lymphatic vessels may play an important role in lymphatic metastasis.