膀胱癌早期淋巴转移机理的研究

The mechanism of lymphatic metastasis of bladder cancer

目的探讨膀胱癌及癌周淋巴管形态学特征与盆腔淋巴结转移的机理。方法应用５′ＮａｓｅＡＬＰ双重组织化学及透射电镜观察２４例膀胱癌组织和癌旁膀胱壁组织内淋巴管的细微分布、形态和结构。结果发现膀胱癌组织内有较多新生的毛细淋巴管、癌周组织中毛细淋巴管的分布明显高于正常组织，随着癌的浸润发展，癌周组织毛细淋巴管数量增多、密度增高、形态结构变异，内皮细胞间连接呈开放状态，且可见到癌栓经开放之通道侵入毛细淋巴管内。结论膀胱癌及癌周组织淋巴管增生。

Objective To elucidate the mechanism of lymphatic metastasis of bladder carcinoma. Methods The distribution,density,morphologic and structural features of pericarcinoma tissues and carcinoma lymphatics of bladder carcinoma were studied in 24 cases of bladder carcinoma and in 7 normal tissures by means of 5' nucleotidase alkaline phosphatase double histochemical reaction and electron microscopy. Results Many newborn lymphatic capillaries in the carcinoma and higher density of lymphatic distribution in the pericarcinoma tissue were observed.With the growth and advance of the cancer,the density of lymphatics in the pericarcinoma tissue became higher further and morphological changes appeared.The junction of endothelium became opened and tumor embolus could invade into the lymphatics through the opened junction. Conclusions It was suggested that proliferation and structural change of lymphatics in the pericarcinoma tissue might enhance the chance of cancer cell invasion into the lymphatics providing a new field for the study of early lymphatic metastasis in bladder cancer.