声门上型喉癌淋巴管生成规律及与临床病理因素的关系

目的：探讨声门上型喉癌淋巴管生成的规律及与临床病理因素的关系。方法：应用免疫组织化学方法及全自动图像分析仪检测50例声门上型喉癌中心区、交界区及正常喉黏膜淋巴管的数量和形态，分析其规律及与临床病理因素的关系。结果：中心区未见到有腔淋巴管的生成，正常喉黏膜仅检测到少量淋巴管无法计数密度，交界区有大量淋巴管生成扩张。交界区淋巴管密度与T分期、分化程度、淋巴结转移相关，T1～2低于T3～4，差异有统计学意义（P〈0．01）；高-中分化低于低分化，差异有统计学意义（P〈0．01），高中分化之间差异无统计学意义；N0低于N^＋，差异有统计学意义（P〈0．01）。结论：声门上型喉癌在交界区癌间质和癌旁均有淋巴管生成，癌细胞可经此通路转移到区域淋巴结，此结论为处于试验阶段的抑制淋巴管生成的抗肿瘤药物的临床应用提供了理论依据；检测交界区淋巴管数量可帮助医生正确评估预后，制定更有效的治疗方法。

The rule of lymphatic formation and the relationship between lymphatic formation and clinical pathological factors in supraglottic carcinoma

Objective:To investigate the rule of lymphatic formation and the relationship between lymphatic formation and clinical pathological factors in supraglottic carcinoma.Method:Immunohistochemistry method and automatic image analysis technique were applied to observe the lymphatic quantity and state in central carcinoma tissue,join tissue and normal larynx mucosa of supraglottic carcinoma.Analyze the rule and the correlation between lymphatic formation and T stage,differentiation,lymph metastasis.Result:The lumen-lymphatic formation was not seen in central carcinoma tissue.There are little lymphatic in normal larynx mucosa whereas many lymphatic formation in join area.The lymphatic density in join tissue is correlated with T stage,differentiation and lymph metastasis: T1~2 lower than T3~4 and the difference is significant(P<0.01);The difference between high and middle differentiationis is insignificant(P=0.212);High-middle differentiation lower than low differentiation and the difference is significant;N0 lower than N+ and the difference is significant(P<0.01).Conclusion:In join area,there are lymphatic formation both in carcinoma area and para-tumor area.Tumor cell can go to lymph nodes via this pathway.This conclusion provides theoretical basis for clinical utility of the anti-tumor medicines which inhibitate lymphatic formation.It can help surgeons forcast prognosis and select more effective treatment method to observe join lymphatic vessel quantity.