弹力纤维染色在结直肠癌脏层腹膜弹力层侵犯及血管侵犯中的应用价值及临床意义

Application value and clinical significance of elastica staining in visceral peritoneal elastic lamina invasion and vascular invasion of colorectal cancer

目的 探讨弹力纤维染色在判断结直肠癌脏层腹膜弹力层侵犯和血管侵犯中的应用价值及临床意义.方法 选取2013年1月~2016年12月山东省青岛市市立医院结直肠癌组织学标本75例,采用常规HE染色和地衣红弹力纤维染色的方法观察标本中的脏层腹膜侵犯、脏层腹膜弹力层侵犯和血管侵犯情况,并观察与淋巴结转移、血管侵犯、神经侵犯及肿瘤出芽之间的关系.结果 弹力纤维染色脏层腹膜弹力层肿瘤侵犯的检出率高于HE染色的检出率,差异有统计学意义(P<0.05);脏层腹膜弹力层侵犯阳性患者其淋巴结转移、静脉侵犯及肿瘤出芽发生率高于脏层腹膜弹力层侵犯阴性的患者,差异有统计学意义(P<0.05);脏层腹膜弹力层侵犯阳性患者其神经侵犯发生率高于脏层腹膜弹力层不存在的患者,差异有统计学意义(P<0.05);弹力纤维染色血管侵犯检出率高于HE染色,差异有统计学意义(P<0.05),其特异性为100.0%,敏感性为65.8%.结论 弹力纤维染色能够明显提高结直肠癌的脏层腹膜弹力层侵犯和血管侵犯检出率,脏层腹膜弹力层侵犯阳性的患者提示肿瘤预后不良,脏层腹膜弹力层侵犯可能作为结直肠癌分期的临床病理指标之一.

Objective To explore the application value and clinical significance of elastica staining in identifying visceral peritoneal elastic lamina invasion and vascular invasion of colorectal cancer.Methods From January 2013 to December 2016,75 colorectal cancer histological specimens were selected from Qingdao Municipal Hospital,the peritoneal invasion of the visceral layer,the peritoneal invasion of the visceral layer and the vascular invasion in the specimens were observed by conventional HE staining and lichen red elastic fiber staining.The relationship among lymph node metastasis,vascular invasion,nerve invasion and tumor budding were observed.Correlations between visceral peritoneal elastic lamina invasion and lymph metastasis,vascular invasion,perineural invasion,tumor budding were also investigated.Results Elastic fiber staining results showed the positive rate of visceral peritoneal elastic lamina invasion was higher than that of HE staining,and the difference was statistically significant(P<0.05);the incidence of lymph metastasis,vascular invasion and tumor budding in visceral peritoneal elastic lamina invasion positive cases were higher than those in peritoneal elastic lamina invasion negative cases,the differences were statistically significant(P<0.05);the incidence of nerve invasion in patients with positive visceral peritoneal elastic layer invasion was higher than that in patients without visceral peritoneal elastic layer invasion,and the difference was statistically significant(P<0.05);elastic fiber staining revealed that the detection rate of vascular invasion was higher than HE staining,and the difference was statistically significant(P<0.05),and with 100.00%specificity and the 65.8%sensitivity.Conclusion Elastic fiber staining can significantly improve the detection rate of visceral peritoneal elastic layer invasion and vascular invasion.Patients with positive visceral peritoneal elastic layer invasion suggest poor tumor prognosis,and visceral peritoneal elastic layer invasion may be one of the clinicopathological indicators for colorectal cancer staging.