喉癌组织微淋巴管密度和微血管密度的定量测定及临床意义

The quantitative determination and its clinical significance of lymphatic vessel density and microvessel density in laryngeal carcinoma

目的探讨不同喉部病变组织微淋巴管和微血管的密度及临床意义。方法选择喉鳞状细胞癌40例及喉鳞状上皮不典型增生和成人喉乳头状瘤患者各20例病变标本，分别进行微淋巴管及微血管染色。结果喉鳞状细胞癌、喉鳞状上皮不典型增生和喉乳头状瘤组织中LVD及MVD值之间差异均有统计学意义（P〈0．01）。高分化癌组织LVD和MVD显著高于中、低分化癌组织，TNMⅢ～Ⅳ期癌组织LVD和MVD显著高于Ⅰ～Ⅱ期癌组织，淋巴结转移的癌组织LVD和MVD显著高于无淋巴结转移的癌组织（P〈0．01）．声门上型癌组织MVD显著高于声门型癌组织（P〈0．05）。IJVD、MVD及TNM分期是影响喉鳞状细胞癌患者生存时间的独立危险因素（P〈0．05）。结论喉癌的发展和转移与微淋巴管及微血管的密度有关，两者都是喉癌预后的负性因子，定量测定可作为喉癌预后的指标。

Objective To investigate the lymphatic vessel density （LVD） and microvessel density （MVD） in different laryn geal lesions and the clinical significance of them. Methods Quantitative determination of lymphatic vessel density and mi crovessel density in laryngeal cancer （n = 40）, laryngeal squamous dysplasia （n = 20） and laryngeal papilloma in adults （n = 20） were done. Results Laryngeal squamous cell carcinoma, laryngeal squamous dysplasia and laryngeal papilloma tissue differences between LVD and MVD were statistically significant （P 〈 0.01）. LVD and MVD of poorly-differentiated cancer tissue were significantly higher than in well-differentiated cancer tissue; LVD and MVD of TNM Ⅲ- IV of cancer tissue were significantly higher than the TNM I - Ⅱcancer tissues, LVD and MVD of with lymph node metastasis in cancer tis sues were significantly higher than those without lymph node metastasis in cancer tissues （P 〈 0.01）; MVD of supraglottic cancer were significantly higher than the glottic cancer group （P 〈 0.05）. LVD, MVD and TNM stage were the independent risk factors for laryngeal squamous cell carcinoma of the survival time of patients （P 〈 0.05）. Conclusion The development and transferation of the laryngeal tumor is related to micro lymphatic and capillary density, both are laryngeal negative prognostic factors, quantitative determination of the index can be as a predictor of laryngeal tumor prognosis.