人结肠癌和胃癌淋巴管形态结构的研究

Morphologic Study of the Structures of the Lymphatics in Human Colon and Gastric Cancer

目的 研究人结肠癌和胃癌组织淋巴管的微细分布、超微结构特征和组织化学染色特性 ,观察其共同特点 ,为进一步探讨癌组织的淋巴道转移机理提供形态学依据。方法 取临床结肠癌和胃癌病人手术切除的组织 ,按癌组织中央区、周边区及正常区分别取材 ,应用半薄切片光镜观察、超薄切片电镜观察及 5′核苷酸酶 -碱性磷酸酶双重染色和高碘酸 -无色品红 -橙黄G染色的方法 ,对结肠癌和胃癌组织淋巴管的形态结构进行研究。结果 无论在结肠癌和胃癌 ,癌组织中心区均未见淋巴管 ;而癌组织周围区淋巴管的密度较正常区的增高 ,且管径较大 ,形态不一 ;淋巴管内皮细胞及细胞器有明显变化 ,内皮细胞间连接开放增加 ,常见淋巴管管壁的破坏和不完整 ;癌组织正常区的淋巴管分布于各层组织中 ,其超微结构变化不明显。结论 淋巴管只存在于结肠癌和胃癌组织周围区和正常区 。

Objective To study the distribution, ultrastructure and histological features of the lymphatics in human colon and gastric cancer and to provide the morphology theory basis for mechanism of the metastasis by the lymphatics in cancer tissue. Method By means of resin embedded semithin section, ultrathin section, 5′ NASE-ALPASE double staining and Shiff staining, the samples were cut in the center, periphery and normal regions of the postoperative tissue of the colon and gastric cancer respectively for observation of the lymphatic structures by light microscopy and transmission electron microscopy. Results No lymphatic was found in the central area of the colon and gastric cancer tissue, but many lymphatics were found in the periphery region, the density of the lymphatic in the periphery region was much higher than that in normal area, especially in gastric cancer tissue. The morphology of these lymphatic is inconsistent with each other with the cavity dilated, and the changes of the lymphatic endothelium and organelles occur obviously, opening of endothelial junction and the damage of the part of the lymphatic wall was often found. And the lymphatics were found in each layer in the normal region of the cancer tissues. Conclusion The existance of the lymphatics in the periphery and normal region of the colon and gastric cancer tissue suggests that the colon and gastric cancer metastasis along the lymphatics may enter lymphatic lumen through the opening of endothelial junctions and the endothelial dissolution.