肿瘤血管生成、癌周淋巴管增殖与舌鳞癌颈淋巴结转移

Tumor Angiogenesis, Lymphatic Vessel Proliferation, and Their Association with Neck Lymph Node Metastasis of Squamous Cell Carcinoma in Oral Tongue

为探讨肿瘤血管生成、淋巴管增殖、分布变化与舌鳞癌颈淋巴结转移的相关性，利用免疫组化染色方法，以三种抗体（ＵＥＡ—１、ⅧＲ：Ａｇ、ＬＮ）显示并准确地区分出肿瘤组织和正常组织内的毛细血管与淋巴管。结果：肿瘤内及周边毛细血管未出现增殖。癌周毛细淋巴管密度明显高于舌粘膜和肌肉组织中的淋巴管密度（Ｐ＜０．０１），管腔扩张，缺乏基底膜。肿瘤内未发现有淋巴管。单因素与多因素分析：毛细血管、毛细淋巴管密度的变化与颈淋巴结转移均无显著性差异。

umor angiogenesis and peritumoral lymphatic vessel invasion have recently shown to be related to tumor progression and metastasis in breast, lung and colon cancer. We examined their association with neck lymph node metastasis in squamous cell carcinoma of oral tongue. Sixty patients were reviewed, samples were cut and immunohistochemically stained for factor Ⅷ, UEA-1, Laminin, which allowed the microvessels and lymphatic vessels to be identified and counted per 200× field by light microscope. Lymphatic counts in the tissue immediately adjacent to the tumor were higher than those in normal mucosa and muscle (P<001). Local growth of the tumor was accompanied by peritumoral lymphatic proliferation and abundant dilated lymphatic vessels. No intra-tumoral lymphatic vessels were observed. The intratumoral and peritumoral microvessel density was not higher than that of normal mucosa and muscle. Microvessel and lymphatic vessel density did not correlated with neck nodal metastasis by multivariate analysis. This result was in contradistinction to those recently reported for other tumor sites. Our investigation suggested that the important factors involved in nodal metastasis were increased peritumoral lymphatic density, distinct dilatation, and lack of basement membrane.