胆囊良恶性病变组织中肿瘤相关巨噬细胞及微血管和淋巴管计数

Counts of Tumor-associated Macrophage,Microvessel and Lymph Vessel in Benign and Malignant Lesions of Gallbladder

【目的】研究胆囊良恶性病变组织中肿瘤相关巨噬细胞(TAM)、微血管(MV)和淋巴管计数(LV),探讨其临床病理意义及在胆囊腺癌中相互关系。【方法】108例胆囊腺癌、46例癌旁组织、15例腺瘤性息肉和35例慢性胆囊炎手术切除标本常规制作石蜡包埋切片,TAM、MV和LV染色均为SP免疫组化法,高倍光镜下随机计数10个视野。【结果】胆囊腺癌TAM、MV和LV计数明显地高于癌旁组织、腺瘤性息肉和慢性胆囊炎(P<0.01);腺瘤癌变或高分化腺癌、肿块最大径≤2cm、无淋巴结转移及周围组织未侵犯病例TAM、MV和LV计数明显低于低分化腺癌、肿块最大径>2cm、淋巴结转移及侵犯周围组织病例(P<0.05);胆囊腺癌中TAM计数与MV和LV计数均存在高度密切正相关(TAM与MV,r=0.65,P<0.01;TAM与LV,r=0.58,P<0.01;MV与LV,r=0.32,P<0.05)。【结论】TAM,MV和LV计数可能是反映胆囊癌发生、进展、生物学行为、转移或侵袭潜力及预后的重要生物学标记物,TAM浸润可能与肿瘤血管和淋巴管生成有关。

[Objective] To study the counts of tumor-associated macrophage （TAM）, microvessel （MV） and lymph vessel （LV） in gallbladder adenocarcinoma, pefitumoral tissues, adenomatous polyp and chronic cholecystitis with regard to their diagnostic and prognostic value from a clinicopathological perspective. [ Methods ] SP immuno- histochemistry method was used for the stain of TAM, MV, and LV in routinely paraffin-embedded sections from the samples of gallbladder adenocarcinoma （n=108）, peritumoral tissues （n=46）, adenomatous polyp （n=lS）, and chronic cholecystitis （n=35）, followed by positive-counting on 10 random field under high power microscope. [Results] The counts of TAM, MV, and LV were significantly higher in the gallbladder adenocarcinoma than those in the peritumoral tissues, adenomatous polyp, and chronic cholecystitis （P 〈 0.01）. The counts of TAM, MV, and LV were significantly lowered when the tumor were cancerate from adenomatous polyp, or welldifferentiated, or less than 2 cm in the maximal diameter, or negative in lymphatic involvement and peritumoral infiltration （P 〈 0.05）. Significant positive-correlation were found among the counts of TAM and MV and LV in gallbladder adenocarcinorna （correlation coefficient： TAM vs MV, r=0.65, P 〈 0.01 ; TAM vs LV, r=0.58, P 〈 0.01; MV vs LV, r=0.32, P 〈 0.05）. [Conclusions] The counts of TAM, MV, or LV presented as important factors associated with carcinogenesis, advancement, biological behavior, metastasis, invasive potential and prognosis of gallbladder carcinoma, TAM deposit might indicating the angiogenesis and lymphoangiogenesis of gallbladder adenocarcinoma.