涎腺恶性肿瘤中血管生成拟态的表达及临床意义

Expression of vasculogenic mimicry in malignant salivary gland tumors and its clinical significance

目的探讨涎腺恶性肿瘤中血管生成拟态(VM)是否存在及其临床意义。方法采用CD31和PAS双重染色技术对43例涎腺恶性肿瘤组织及5例正常涎腺腺体组织进行CD31和PAS双重染色,探讨涎腺恶性肿瘤VM的结构形态,分析VM与腺样囊性癌临床分型的关系。结果涎腺恶性肿瘤组织中存在VM结构,正常涎腺腺体组织中未见VM结构。43例涎腺恶性肿瘤组织中,8例(18.6%)存在VM结构,其中5例腺样囊性癌VM阳性,1例黏液表皮样癌VM阳性,1例多形性腺瘤VM阳性,1例肌上皮癌VM阳性;在光镜下观察可见VM结构为由肿瘤细胞围成的无内皮细胞衬附的管道样结构和PAS染色阳性的网络样VM结构,在肿瘤细胞和管腔间被一层PAS染色阳性物质间隔或被PAS阳性物质填充,部分病例中可见VM结构与相邻的CD31及PAS阳性血管相通,可在管腔中发现红细胞;涎腺恶性肿瘤组织中VM的数量与血管数量呈正相关(r=0.548,P﹤0.01);实质型腺样囊性癌组织中VM阳性率高于腺样-管状型腺样囊性癌组织,差异有统计学意义(P﹤0.05)。结论涎腺恶性肿瘤中存在VM,可为抗血管治疗提供新的靶点。

Objective To investigate the presence and clinical significance of vasculogenic mimicry(VM)in malignant salivary gland tumors and to determine the clinical significance.Method The double staining technique of CD31 and PAS was used in 43 cases of malignant salivary gland tumor tissues and 5 cases of normal salivary gland tissues to investigate the morphological structure of VM in malignant salivary gland tumors and to analyze the relationship between VM and clinical classification of adenoid cystic carcinoma.Result There was VM structure in malignant salivary gland tumor tissues,while no in normal gland tissues.Among the 43 cases of malignant salivary gland tumor tissues,8(18.6%)had VM structure,of which 5 cases were adenoid cystic carcinoma,1 case was with mucoepidermoid carcinoma,1 case was pleomorphic adenoma,and another one had myoepithelial carcinoma;under light microscope,the VM structure was seen as tubular structure surrounded by tumor cells in absence of endothelial cell adhesion,and network-like structure with positive PAS staining,notably,tumor cells and the lumen were separated or filled by a layer of PAS staining-positive substance,while in some cases,the VM structure was connected with adjacent CD31 and PAS positive-blood vessels,where erythrocytes could be found in the lumen;the number of VM in malignant salivary gland tumor was positively correlated with the number of blood vessels(r=0.548,P<0.01);the positive rate of VM in solid adenoid cystic carcinoma was higher than that in its tubular variant,and the difference was statistically significant(P<0.05).Conclusion VM exists in malignant salivary gland tumors,which may new targets for anti-vascular therapy.