喉癌颈淋巴结增生性滤泡反应的临床意义

The immunohistochemical study of hyperplastic follicular response in cervical lymph nodes of laryngeal carcinoma

目的 通过对颈淋巴结中增生性滤泡反应进行定量分析 ,探讨其在喉癌患者抗肿瘤免疫反应中的作用。方法 47例行选择性颈淋巴结清扫术的喉癌患者的 15 7枚颈淋巴结石蜡标本被重新制备 ,用CD 2 0单克隆抗体免疫组化SABC法显示增生性滤泡的分布并计算其密度。结果 定量分析表明 ,术后生存期≥ 5年患者的淋巴结中滤泡数量明显多于生存期 <5年者 (P <0 .0 0 1)。无淋巴结转移患者淋巴结中的滤泡数较有转移组有明显增多 (P<0 .0 0 1)。结论 颈淋巴结中增生性滤泡反应反映了机体免疫系统的抗肿瘤潜能 ,其浸润密度反映了该患者的抗肿瘤免疫状态 。

Objective An immunohistochemical study was performed to prove role of lymph follicular in immune responses against cancer. Methods Paraffin-embedded tissue were measured with immunohistochemical method using monoclonal antibody against CD20 in 157 lymph nodes obtained from elective cervical lymphadenectomy in 47 cases of laryngeal squamous cell carcinomas.Results Quantitative analysis showed that the patients who survived longer than 5 years had significant higher number of follicles in the lymph nodes than those who survived less than 5 years (P<0.001). According to negative or positive lymph node metastasis, there was a statistically significant difference between two groups (P<0.001).Conclusion The results suggest that hyperplastic follicular response may be more directly involved in the host immune reaction against tumor,and the amount of hyperplastic follicular response in cervical lymph nodes can serve as a useful indicator in assessing prognosis of laryngeal carcinomas.