腹膜癌网膜标本中乳斑的形态学研究

Morphological Investigation of Omental Milky Spots in Peritoneal Carcinoma

目的观察腹膜癌网膜标本中乳斑的形态学特征。方法采用HE以及免疫组织化学SP法对腹膜癌组织进行染色,分析乳斑形态学特征,定量分析其细胞总数和细胞构成比例,比较不同类型腹膜癌中乳斑各特征参数的差异。结果乳斑的主要形态有四种:圆形、椭圆形、脂肪内不规则形和血管周环形;每个乳斑的周长中位数为2 752像素。免疫细胞是乳斑的主要细胞成分;免疫细胞的主要成分依次为:T淋巴细胞(46.1%)、B淋巴细胞(28.4%)、巨噬细胞(12.4%)和其他免疫细胞(13.1%);乳斑内血管丰富,微血管中位数为4个。间皮细胞排列疏松,中位数为5个,缺少间皮细胞覆盖的乳斑占38.1%。在胃癌和直肠癌患者大网膜中,乳斑免疫细胞总数、周长、微血管数、间皮细胞数、T细胞数、巨噬细胞数的差异无统计学意义(P>0.05),B细胞数的差异有统计学意义(P<0.001)。结论乳斑是大网膜的初级免疫组织,也是腹膜癌发生发展的结构基础,分析其形态结构和细胞组成有助于深入认识腹膜癌的病理机制。

Objective To analyze the morphological features of omental milky spots（MS） in peritoneal carcinoma.Methods Hematoxylin-eosin（HE） staining and immunohistochemistry（IHC） were used to analyze the omental MS in peritoneal carcinoma（PC） patients.We focused on the morphological features of MS and conducted quantitative analysis on their cells number and cellular constituent.Meanwhile,the differences of MS parameters were analyzed.Results Various shapes of MS were mainly round（14.5%）,oval（18.0%）,irregular form in the adipose（14.0%） and perivascular annulus（11.5%）.The median perimeter of MS was 2 752（range 817-7 753） computer-based pixels.The median value of immune cells in one MS was 141（43-650）.Immune cells were the main component of MS,comprising T lymphocytes（46.1%）,B lymphocytes（28.4%）,macrophages（12.4%） and other immune cells（13.1%）.Relatively high density of blood vessels in MS could be calculated by micro-vessel density（MVD） as 4（0-13）.The median number of mesothelial cells loosely arranged in the surface layer was 5（0-51）.The percentage of MS without surface mesothelial cells was 38.1%.The total number of immune cells,perimeter,MVD,the number of mesothelial cells,T lymphocytes and macrophages in omental MS were not signifi cant different between rectal cancer patients and gastric cancer patients（P〉0.05）,while the number of B lymphocytes was signifi cantly different（P〈0.001）.Conclusion Milky spots are the primary immune tissues of omentum and the structural bases for the development and progression of PC.Analyzing the morphology and cellular constituent promotes studying the pathomechanism of peritoneal carcinoma.