双向分化肿瘤血管生成拟态的组织微阵列研究

Microarray study of vasculogenic mimicry in bi-directional differentiation malignant tumor

目的 探讨在双向分化肿瘤中是否存在肿瘤细胞通过自身变形并模拟产生血管样通道而达到自身血液供应的方式 ,即血管生成拟态 (VM )。方法 采用免疫组化和PAS双重染色技术研究双向分化肿瘤内血管的生成模式 ,收集双向分化肿瘤恶性黑色素瘤 (高度恶性 30例、低度恶性 30例 ) ,滑膜肉瘤 (高度恶性 2 3例、低度恶性 13例 ) ,间皮肉瘤 (2 6例 ) ,上皮样肉瘤 (4例 )及具有双向分化倾向的腺泡型横纹肌肉瘤 (高度恶性 16例、低度恶性 16例 )共 15 8例 ,制作成组织芯片 ,进行CD31和PAS双重染色 ,通过网格计数法比较这些肿瘤中CD31和PAS阳性图案围成的管道面积 ,以其差异研究血管生成拟态。并且比较高度恶性肿瘤和低度恶性肿瘤血管生成拟态的差异。结果 双向分化肿瘤中CD31和PAS阳性图案围成的管道面积差异具有统计学意义 (P <0 .0 1)。同时观察到细胞异型性小的双向分化肿瘤形成血管生成拟态的例数明显少于瘤细胞异型性大的双向分化肿瘤形成血管生成拟态例数 ,其差异具有统计学意义 (P <0 .0 5 )。在明显具有血管生成拟态的点阵中见PAS阳性的血管样图案内无内皮细胞衬覆但有红细胞存在 ,并可见双向分化肿瘤的瘤细胞可表达CD31抗原和PAS阳性物质。

Objective To explore if vasculogenic mimicry (VM) exists in bi-directional differentiation malignant tumor. Methods New sections were made from 158 paraffin sections of bi-directional malignant tumors, including malignant melanoma (n=60), synoviosarcoma (n=39), rhabdomyosarcoma (n=29), malignant mesothelioma (n=26), and epithelioid sarcoma (n=4). The representative points in the paraffin sections were labeled and two tissue microarrays were made, one including 60 cases of malignant melanoma, and the other including the other tumors. Immunohistochemical staining of platelet-endothelial cell adhesion molecule (CD31 antigen) and periodic acid Schiff (PAS) staining were conducted. Microscopy was made and the areas of vessel-like channels consisted of CD31 antigen-positive tumor cells and of PAS positive material were calculated. Results PAS positive material or CD31 positive material were observed in these bi-directional tumor cells. In the tumors vessel-like channels could be found, made of PAS positive material lined with CD31 negative tumor cells and red blood cells inside the channel, or made of tumor cells with CD31 positive material. The area of the former vessel-like channels was significantly smaller than that of the latter (P<0.01). VM was found in 16 of the 39 cases of the highly malignant synoviosarcoma and acinar type rhabdomyosarcoma, a ratio higher than that among the cases of synoviosarcoma and acinar type rhabdomyosarcoma with lower malignancy (5/29) (P<0.05). Conclusion VM exists in bi-directional differentiation malignant tumors.