组织芯片免疫组化检测皮肤鳞癌间质反应对癌病理分级的影响

Tissue microarray immunohistochemical detection of the impact of stromal reaction in the skin squamous cell carcinoma to its pathological grade

目的:在我国皮肤鳞状细胞癌(skinsquamous cell carcinoma,SSCC)是皮肤恶性肿瘤中最常见的肿瘤,本文运用组织芯片免疫组化技术研究癌间质对癌分级的影响。方法:将91例SSCC制备成组织芯片,通过免疫组化技术检测癌间质中免疫活性细胞,包括CD68阳性的巨噬细胞(Mφ)、IL-2R/CD25α阳性的淋巴细胞(LC)、CD117阳性的肥大细胞(MC),细胞外基质中纤维连接蛋白(fibrinectin,FN)和基质金属蛋白酶(matrix metalloprotienases,MMPs)MMP-9、MMP-2及CD34阳性的微血管密度(microvessel density,MVD),研究其与SSCC病理分级的相关性。结果:在SSCC癌巢周围间质中均有免疫活性细胞反应,各种免疫活性细胞量均与癌分级呈负相关(P<0.01);SSCC中FN表达有3种形式,其中细胞FN和基膜FN的减少在癌不同分级中差异有统计学意义(P<0.01)而间质FN表达在不同分化中差异无统计学意义。MMP-2、MMP-9在癌细胞与间质细胞中均有分布,并在癌细胞浸润前缘及癌细胞与间质细胞接触处明显增多,在癌终末分化的角化珠中未见分布。癌中MMP-2、MMP-9表达增强与SSCC分级呈正相关(P<0.01)。MVD与癌分级呈正相关(P<0.01)。结论:在SSCC中癌间质构成了癌生长的环境,显著影响与癌分化相关的病理分级。

Objective：In China,skin squamous cell carcinoma （SSCC） is the most common malignant skin tumor.In this paper,tissue microarray immunohistochemical was used to investigate the impact of stromal reaction in the SSCC to its pathological grading.Methods：91 cases of SSCC were prepared into a tissue microarray,immunohistochemical staining was taken to detect the immunocompetent cells in cancer stroma,including CD68-positive macrophages （Mφ）,IL-2R/CD25αpositive lymphocytes（LC）,CD117-positive mast cells （MC）,and fibrinectin （FN）,matrix metalloproteinase （MMPs） MMP-9,MMP-2,and CD34-positive microvessel density （MVD）,and study its correlation with the pathological grading of SSCC.Results：The immunocompetent cell response was in the surrounding stroma of SSCC cancer nest,the amount of various immunocompetent cells were negatively correlated with cancer grade （P〈0.01）;FN distrubuted 3 patterns in SSCC,the reduction of cellular FN and basement membrane FN had significant difference in different cancer grading （P〈0.01）;MMP-2 and MMP-9 were in both cancer cells and stromal cells,and increased significantly in the leading edge of invasive cancer cells and in the part where cancer cells contact with stromal cells,while they were not seen in its terminal differentiation of keratinizing pearls.The increased expression of MMP-2 and MMP-9 in carcinoma were positively correlated with the SSCC grade （P〈0.01）;MVD was positively correlated with cancer grade.Conclusion：In the SSCC,cancer stroma constitutes the growth environment of cancer,and significantly affects its differentiation.