胃癌组织淋巴管和血管生成与增殖细胞关系的研究

Relationship study between proliferating cell and lymphatic vessel and angiogenesis in gastric cancer

目的探讨胃癌组织中淋巴管和血管生成与增殖细胞的关系。方法对67例胃癌标本分别于癌中心区和癌周边区进行免疫组织化学染色，采用D2—40、VEGFR—C及受体VEGFR-3检测微淋巴管密度（MLD），CD34和CD31检测微血管密度（MVD），Ki-67标记观察细胞的增殖情况。结果胃癌中心区有较少闭锁的条索状淋巴管；癌周边区淋巴管增多，且管腔多呈扩张状态，中心多有癌栓形成。胃癌中心区的淋巴管密度（33．6±13．9）与癌周边区（61．7±21．4）比较显著性减少（P〈0．01）。胃癌组织中微血管分布和数量的差异与微淋巴管类似。胃癌中心区有灶性少量分布的Ki-67阳性肿瘤细胞，癌周边区有密集分布的大量Ki-67阳性肿瘤细胞，尤其是癌周1个低倍视野（10倍）内细胞增生显著。胃癌中心区的Ki-67阳性细胞数（49．2％）与癌周边区（73．5％）比较显著性减少（P〈0．05）。结论胃癌组织中存在新生淋巴管，血管、以及大量Ki-67阳性细胞，三者的分布主要是癌组织的前缘，即胃癌周边区的1个低倍视野（10倍）内。检测胃癌组织中MLD、MYD、Ki-67阳性细胞是判断胃癌预后的重要参考指标。胃癌周边区扩张的微淋巴管、微血管和Ki-67阳性细胞增多，其预后差，反之预后好。

To study the relationship between proliferating cell and lymphatic vessel and angiogenesis in gastric cancer. Methods We observed the central cancer tissues and the peritumoral tissues of 67 patients with gastric carcinoma by immunohistochemistry. Using 1）2 - 40 ,VEGFR - C and VEGFR - 3 detected the micro - lymphatic density （ MLD）, microvessel density （MVD） were evaluated by immunohistochemistry with CD31 and CD34 antibodies. The proliferation of the cells was labeled by Ki - 67. Results There is a few atresic streak lympgatic vessel in the central cancer tissues, but in the peritumoral tissues lymphatic increased and dilated, it appears adenoid structure. To compare with micro - lymphatic density in the central cancer tissues （ 33.6 ± 13.9 ） and the peritumoral tissues（ 61.7 ± 21.4）, the result is significantly different（ P 〈 0. 01 ）. The differences in the distribution and amount of microvessel are similar to lympgatie vessel. There is a few focal distribution Ki - 67 positive carcinoma, but in the peritmnoral tissues the situation is reverse especially in one lowpower size （ × 10）. Compared with Ki -67 positive cells in different tumor region, in the central cancer tissues Ki -67 positive cells decreased markedly（ P 〈 0. 01 ）. Conclusion There exist neonatal lymphatic vessels,blood vessel and many Ki -67 positive carcinoma in gastric cancer. All of them distribute anterior border of carcinoma tissues ,especially in one low -power size（ × 10）. The MLD,MVD and Ki -67 positive carcinoma might be an important index for the prognosis of gastric carcinoma. The more lymphatic microvessel, microvessel and Ki - 67 positive carcinoma in the peritumoral tissues, the poorer prognosis, vice versa, good prognosis.