舌鳞癌癌周淋巴管密度与颈部淋巴结转移相关性研究

Relationship between intratumoral lymphatic vessel density and cervical lymph node metastasis in tongue squamous cell carcinoma

【目的】观察舌鳞癌病灶组织淋巴管分布特点,探讨人舌鳞癌癌灶及癌周淋巴管密度与淋巴结转移的相关性,及其可能的淋巴道转移机制,分析淋巴管生成与临床病理指标之间的关系。【方法】采用免疫组织化学方法标记62例病理组织标本中的淋巴管,并计数人舌鳞癌癌灶与癌周组织淋巴管密度值。【结果】观察可见癌周淋巴管数量较癌内增多,管壁菲薄,多见扩张、开放状态。舌鳞癌伴颈部淋巴结转移阳性组癌周淋巴管密度较淋巴结转移阴性组高(P<0.05),癌灶内与癌周淋巴管密度与患者的年龄、性别、T分期均无相关性。【结论】(1)人舌鳞癌组织中存在大量新生淋巴管,主要分布于癌周围组织。(2)与舌鳞癌伴颈部淋巴结转移阴性组相比较,淋巴结转移阳性组癌周淋巴管密度明显增高。(3)舌鳞癌癌周淋巴管密度的增加是癌细胞转移的病理解剖学基础,可能与淋巴结转移有关,观测舌鳞癌组织中淋巴管的生成对预测癌淋巴道转移有一定价值。

[Objective]To observe the characteristics of distribution of lymphatic vessels in tongue squamous cell carcinoma, discuss the relationship between lymphatic vessel density of intratumoral tissues and peritumoral tissues and lymph node metastasis, as well as the possible mechanism, and analyze the relationship between lymphangiogenesis and clinicopathological indexes. [Methods] This study used an immunohistochemical method to mark the lymphatic of tongue squamous cell carcinoma sample in 62 cases and calculated the lymphatic vessel density. [ Results]There was more lymphatic vessel in the peritumoral tissues than in the intratumoral tissues, which presented an opened and dilated state. The peritumoral lymphatic vessels density in case with lymph node metastasis was significantly higher than that without lymph node metastasis（P 〈 0.05）. Both intratumoral and peritumoral lymphatic vessel density had no correlation with the age, gender and T stage. [Conclusions] （1） A large number of new lymphatic vessels are in tongue squamous cell carcinoma, and most of them distribute in the peritumoral tissues. （2） The peritumoral lymphatic vessel density in case with lymph node metastasis is significantly higher than that without lymph node metastasis. （3） The increase of peritumoral lymphatic vessel density of tongue squamous cell carcinoma suggests that peritumoral lymphatic vessel is the anatomic basis of lymph node metastasis. Observing the lymphangiogenesis of tongue squamous cell carcinoma is important in predicting lymph node metastasis.