喉鳞状细胞癌瘤内淋巴管生成与淋巴转移关系的研究

Study on relationship between intratumoral lymphangiogenesis of laryngeal squamous cell carcinoma and lymphatic metastasis

目的:探讨喉鳞状细胞癌(LSCC)瘤内淋巴管生成与淋巴转移的关系,为LSCC转移和预后的判定以及治疗提供一定的理论依据。方法:通过免疫病理学方法计数LSCC组织中淋巴管密度,通过分子生物学方法检测中血管内皮生长因子-C(VEGF-C)的表达,统计学方法对淋巴管密度(LVD)和患者性别、肿瘤TNM分期、VEGF-C表达和肿瘤分化程度进行分析,得出相关性结论。结果:喉癌瘤体内有新生淋巴管存在,喉癌组织中VEGF-CmRNA的平均水平与正常组织之间存在明显差异(P<0.05),瘤组织比正常组织高4～5倍,而且喉癌组织内VEGF-C的水平与瘤内LVD高低之间差异有统计学意义(P<0.05),LVD在患者的性别,临床T分期以及肿瘤的分化程度各组之间均差异无统计学意义(均P>0.05)。而与N分期内差异有统计学意义(P<0.05)。结论:LSCC瘤组织中存在小的增殖性淋巴管且LSCC瘤内LVD的增高与肿瘤淋巴转移有关;VEGF-CmRNA在LSCC组织中的表达要比正常对照组织高,且VEGF-CmRNA的高表达可能会通过促进瘤内淋巴管的增生来促进喉癌的淋巴转移。

Objective：To elucidate the relationship between the intratumoral lymphangiogenesis and lymphatic metastasis, and provide some theoretic evidence for the judgement of lymph node metastasis and prognosis of laryngeal squamous cell carcinoma （LSCC）, also for the treatment. Method： Immunohistochemical analysis was performed to 50 specimens of LSCC with lymphatic endothelial marker （Lymphatic vessel endothelial hyaluronan receptor- 1 LYVE-1）, the vascular endothelial marker CD34 and the pKi67 proliferation marker to record lymphatic vessel density （LVD）. Quantitation of lymphangiogenesis growth factor VEGF-C by RT- PCR was performed to 30 specimens of LSCC. Finally the correlation between LVD and tumor TNM grade, VEGF-C mRNA, grade of differation was analyzed with statistics methods. Result： Newly proliferating lymphatic vessel were observed in all LSCC. The median copy number of VEGF-c mRNA was 4-5-fold higher in LSCC than in adjacent normal tissue. There was correlation between tumor VEGF-C mRNA copy number and intratumoral LVD（ n= 30, P 〈0.05）, there was no significant association between LVD and sex, T stage and grade of differation（ n= 50, P 〉0.05）but N stage（ n = 50, P 〈0.05）. Conclusion：Newly proliferating lymphatic vessels existed in LSCC. There was correlation between high levels of LVD in LSCC than in normal tissue. And the high level of VEGF-C may accelerate the lymphatic metastasis by promoting the proliferation of intratumoral lymphatic.