食管癌旁组织席卷包埋大切片的临床病理特征

Clinicopathological characteristics of large tissue sections wrapped around esophageal carcinoma

目的探讨食管癌旁组织多中心不典型增生的临床病理特征与淋巴细胞浸润的相关性。方法对719例食管癌手术切除标本制作癌旁席卷包埋大组织切片(沿癌组织外缘纵行切取宽1 cm、长7~15 cm的癌旁组织,在黏膜下层和浅肌层间分离后,将黏膜层和黏膜下层作卷席状包埋)。每例制作3~4块席卷石蜡块,每个蜡块5μm厚连续切片,取5~10张切片,行HE染色和组织病理学观察。结果719例食管癌旁组织中非多中心食管上皮不典型增生227例,占31.6%;多中心食管上皮不典型增生194例,占27.0%;多中心食管上皮不典型增生个数与淋巴细胞浸润的相关性分析显示:多中心食管上皮不典型增生个数与淋巴细胞浸润程度存在正向的弱相关(r=0.2,P<0.001)。结论通过席卷包埋大切片发现食管癌旁组织中可见大量多中心不典型增生病灶,这或许是食管癌多中心癌变的来源;食管鳞状上皮不典型增生与淋巴细胞浸润之间存在正向相关性。

Purpose To investigate the clinicopathological characteristics of multicenter atypical hyperplasia in the tissues adjacent to esophageal cancer and relationship with lymphocyte infiltration.Methods 719 cases of esophageal cancer resected by surgery were made large tissue slices(1 cm wide and 7-15 cm long tissues were cut longitudinally along the outer edge of the cancer tissue,and then the mucosa and submucosa were separated between the submucosa and the superficial muscle layer,and then the mucosa and submucosa were rolled and embedded).3-4 swept paraffin blocks were made for each case,and 5μm continuous sections were made for each block,5-10 sections were collected,and HE staining and histopathological observation were performed.Results In 719 cases of esophageal cancer,227 cases(31.6%)were atypical hyperplasia of non multicenter esophageal epithelium.194 cases(27.0%)had multicentric esophageal epithelial dysplasia.The correlation analysis between the number of multicenter esophageal atypical hyperplasia and lymphocyte infiltration showed that there was a weak positive correlation between the number of multicenter esophageal atypical hyperplasia and the degree of lymphocyte infiltration(r=0.2,P<0.001).Conclusion A large number of multicenter atypical hyperplasia could found in the adjacent tissues of esophageal carcinoma by sweeping and embedding large sections.Multicenter atypical hyperplasia lesions may be the source of multicenter carcinogenesis of esophageal carcinoma.There is a positive correlation between atypical hyperplasia of esophageal squamous epithelium and lymphocyte infiltration.