甲状腺乳头状癌组织坏死后矿化特征研究

Characteristics on Mineralization Resulted from Tissue Necrosis in Papillary Thyroid Carcinoma

组织坏死后矿(钙)化是甲状腺癌病灶中普遍存在的钙化形式之一,与病变关系密切。利用光学显微镜、环境扫描电镜、高分辨透射电镜及显微红外光谱研究了6例甲状腺乳头状癌中的组织坏死后矿化特征。结果表明,组织坏死后矿化往往发生在胶原纤维丰富的位置,与胶原关系密切。矿化表现出2种形态,矿(钙)化灶内为较为致密的隐晶集合体,其表面及其附近的胶原上沉淀有许多微米级矿化小球,离矿化灶较远的胶原纤维上也散布有矿化小球。一些矿化小球边缘还发育絮状矿化物质,使之形成绒球状外貌。矿化物质结晶程度均较差,由纳米多晶组成。钙化灶中央较致密部分的n(Ca)/n(P)比较高,接近羟基磷灰石的理论比值,而其边缘以及矿化小球的n(Ca)/n(P)比均较低,可能含有磷酸八钙等低n(Ca)/n(P)磷酸钙系列矿物。矿化初期形成纳米多晶组成的微米级矿化小球,矿化小球逐渐聚集形成大面积的矿化灶。

As a common form of calcification in papillary thyroid carcinoma,the mineralization resulted from tissue necrosis is closely related to the development of disease.The characteristics of mineralization from tissue necrosis of 6 papillary thyroid carcinoma were investigated using optical microscope,environmental scan electron microscope（ESEM）,high-resolution transmission electron microscope（TEM） and micro-Fourier transform infrared spectroscope（FTIR）.The results indicate that the mineralization often occurs in the place with abundant collagens and is closely related to the collagens.There are two patterns of mineralization,small mineralized ball and large aggregate.The relative compact cryptocrystalline aggregates distribute in the inside mineralized focuses.Many micron-sized mineralized balls deposit on the face of the aggregates and collagen fibers nearby.Some small balls also spread on collagen fibers far from the mineralized focuses.The flocculent mineralized matter grow on the rim of some balls which appear pompon-like looks.The mineralized matter are composed of nano-crystals.The relative compact parts of inner mineralized focuses have high Ca/P ratio value,which is close to the theoretical one of hydroxyapatite,whereas rim of the focuses and small balls have lower Ca/P ratio,in which some minerals with low Ca/P ratio such as octacalcium phosphate possible exist.Mineralized small balls formed during the initial stage of mineralization,and the balls gradually aggregate and form large sheet of mineralized focus.