人结直肠黏膜层淋巴管微细分布及超微结构

Normal lymphatic vessel microdistribution and ultrastructure ofhuman colorectum mucosa

目的观察人结直肠正常肠壁黏膜层内淋巴管的形态及结构特点,为探讨结直肠癌淋巴道转移的途经提供形态学依据。方法人结直肠蜡块标本连续切片,通过免疫组化两步法,以鼠抗人D2-40单克隆抗体及鼠抗CD34单克隆抗体为一抗分别标记,光镜下观察抗体标记情况。黏膜层超薄切片电镜下观察淋巴管微观结构。结果 D2-40单克隆抗体免疫组化染色后,在黏膜层,棕黄色显色分布于黏膜固有层与黏膜肌层之间及黏膜肌层内,少量,管壁薄、管腔小,管壁不完整。与CD34染色无重叠。电镜下见黏膜层内少量淋巴管管壁很薄,仅由一层内皮细胞构成,无孔窗,无周细胞,基膜不连续或缺如,内皮细胞间形成端端、重叠或插入连接,管壁外连有锚丝。结论正常人结直肠黏膜层内有淋巴管存在,存在于固有层与黏膜肌层之间及黏膜肌层内,与黏膜下层淋巴管可能存在通道相联,具备淋巴道转移的解剖学基础。

Objective Observing the normal mucosa lymphatic vessel morphology and construction of human colorectum. To supply morphological theory for researching the colorectal carcinoma lymphatic metastasis path. Methods After immunohistochemisty of the serial section of human colorectal paraffinembedded specimen,observe the expression of lymphnodes by the light microscope,and observe the mucosa ultrathin section through the electron microscope to detect lymphatic vessel ultrastructure. Results After the D2-40 monoclonal antibody immunohistochemisty staining,light brown colorations are distributing in the lamina muscularis mucosae and in the level between the amina propria and lamina muscularis,a few of them have thin or unintegrity vessel wall and small lumens,which have no overlap with CD34 staining. A few of lymphatic vessel walls in mucosa are very thin,which are composed of a layer of endotheliocyte. There is no aperture or pericyte and the basement membrane is discontinuous or congenitally absent. Endotheliocyte form end-to-end conjunction,overlap conjunction or insertion conjunction. There is anchoring filaments connecting in outside of the vessel wall. Conclusion Lymphatic vessel exists in normal colorectal mucosa which is located between the lamina and muscularis mucosae and in the muscularis mucosae,and there is likely to be path to the lymphatic vessel of stratum submucosum,so it makes lymphatic metastasis possible in anatomy.