肝细胞癌微循环模式的形态及分布

Morphology and distribution of microcirculation patterns in hepatocellular carcinoma

目的：探讨肝细胞癌中微循环模式的形态结构与分布特点.方法：采用CD34-PAS双重染色法对87例肝细胞癌标本进行染色,判定各种微循环模式组织学结构特点并量化各种微循环模式的分布.结果：肝细胞癌中存在CD34-PAS染色双阳性的内皮细胞依赖性血管,其是血液供应的主要模式;35.63％的病例存在血管生成拟态,且出现肿瘤细胞型和细胞外基质型2种组织学类型;32.18％的病例组织中出现马赛克血管;肿瘤细胞型血管生成拟态、细胞外基质型血管生成拟态和马赛克血管的供血面积之和占全部的36.22％.结论：肝细胞癌组织至少存在4种微循环模式且具有异质性.

Objective： To investigate the morphology and distribution of microcirculation patterns in hepatocellular carcinoma （HCC）. Methods： CD34 and periodic aeid-sehiff （PAS） double staining was performed to observe the histologic structure and morphology of microcirculation patterns in 87 cases of HCC. The distribution of microcirculation patterns was analyzed. Results： Capillaries stained by both CDa4 and PAS were assessed as endothelium-dependent vessel （EDV）, which was the main pattern of blood supply in HCC. Vasculogenic mimicry （VIM） was shown in 35. 63% cases. There were two types of VM according to histologic evidence： patterned tumor cell VM （PAS-positive and CD34-negative tubes containing red blood cells and lined by hepatoma carcinoma cells） and patterned matrix VM （PAS-positive tubes）. Mosaic vascular （MV） composed of tumor cells and endothelial cells was detected in 32. 18% cases. Total area of blood supply with VM and MV was 36.22%, which was able to replace the supply eompensatively to provide the tumor oxygen and nutriment. Conclusion： The results indicate that these four types of microcirculation patterns for tumors exist in HCC. The heterogeneity of HCC microeirculation patterns present an opportunity for anti-vascular therapy.