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早期宫颈鳞癌患者微淋巴管的分布及其临床意义
引用本文:Zhang JP,Lü WG,Chen HZ,Zhou CY,Xie X.早期宫颈鳞癌患者微淋巴管的分布及其临床意义[J].中华医学杂志,2005,85(22):1551-1554.
作者姓名:Zhang JP  Lü WG  Chen HZ  Zhou CY  Xie X
作者单位:310006,杭州,浙江大学医学院附属妇产科医院妇瘤科
基金项目:浙江省教育厅科研项目基金资助(20040217)
摘    要:目的探讨早期宫颈鳞癌微淋巴管形成的临床意义。方法对35例Ⅰb、Ⅱa期的宫颈鳞癌患者的癌组织存档蜡块切片,用Podoplanin单抗免疫染色微淋巴管,图像分析系统定量分析癌内、癌周的淋巴管,并结合临床病理资料分析。结果(1)形态学观察示癌周淋巴管较癌内淋巴管粗大、密集。有淋巴结转移者,癌内淋巴管可见癌细胞。(2)宫颈鳞癌癌周淋巴管密度(LVD)为(31±10)条/mm2,癌内淋巴管密度为(20±10)条/mm2(P<0.01);癌周相对淋巴管面积(LVA)为(0.75±0.40)%,癌内LVA为(0.19±0.11)%(P<0.01)。(3)有盆腔淋巴结转移者的癌内及癌周的LVD、LVA分别为(29±7)条/mm2,(40±5)条/mm2,(0.27±0.10)%,(1.23±0.36)%,无淋巴结转移者为(16±8)条/mm2,(28±9)条/mm2,(0.16±0.09)%,(0.56±0.20)%,(P<0.01,0.01,<0.05及P<0.01)。(4)组织学分级Ⅰ、Ⅱ、Ⅲ级者的癌周LVA及癌内LVD、LVA分别为(0.42±0.10)%,(9±3)条/mm2,(0.06±0.04)%;(0.77±0.37)%,(21±8)条/mm2,(0.21±0.09)%;(0.83±0.46)%,(22±11)条/mm2,(0.21±0.12)%。Ⅱ、Ⅲ级与Ⅰ级比较的P均<0.05,而Ⅱ、Ⅲ者间比较的P>0.05。结论早期宫颈鳞癌高淋巴管分布与淋巴结转移有关。

关 键 词:临床意义  微淋巴管  癌患者  早期  Podoplanin  盆腔淋巴结转移  淋巴管密度  宫颈鳞癌  图像分析系统  无淋巴结转移  P〉0.05  内淋巴管  淋巴管形成  癌周淋巴管  形态学观察  组织学分级  淋巴管分布  LVA  免疫染色  定量分析  资料分析

Tumor lymphangiogenesis in cervical squamous cell carcinoma and its clinical significance
Zhang Jian-ping,Lü Wei-guo,Chen Huai-zeng,Zhou Cai-yun,Xie Xing.Tumor lymphangiogenesis in cervical squamous cell carcinoma and its clinical significance[J].National Medical Journal of China,2005,85(22):1551-1554.
Authors:Zhang Jian-ping  Lü Wei-guo  Chen Huai-zeng  Zhou Cai-yun  Xie Xing
Institution:Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
Abstract:OBJECTIVE: To investigate the clinical significance of lymphangiogenesis in cervical cancer. METHODS: Monoclonal podoplanin was used to immunostain the lymphatic microvessels in the paraffin sections of cervical squamous cancer tissues at the I(b) and II(a) stages from 35 cases kept in the archives. Computer-assisted morphometric analysis was used to quantitatively analyze the lymphatic vessels in intratumor and peritumor areas. The association with clinicopathologic data was analyzed. RESULTS: (1) The lymphatic microvessels were larger and denser in the peritumor areas than the intratumor areas. Cancer cells were found in the intratumoral lymphatic vessels of the lymph metastatic patients. (2) The lymphatic vessel density (LVD) of the peritumor areas was (31 +/- 10) vessels/mm(2), significantly greater than that in the intratumor areas (20 +/- 10) vessels/mm(2), P < 0.01]. The relative lymphatic vessel area (LVA) in the peritumor areas was (0.75 +/- 0.40)%, significantly larger than that of the intratumor areas (0.19 +/- 0.11)%, P < 0.01]. (3) The intra- and peri-tumoural LVD and LVA in the patients with lymph node metastasis were (29 +/- 7) vessels/mm(2) and (40 +/- 5) vessels/mm(2), and 0.27% +/- 0.10% and 1.23% +/- 0.36% respectively, all greater than those of the patients without lymph node metastasis (16 +/- 8) vessels/mm(2) and (28 +/- 9) vessels/mm(2), and (0.16 +/- 0.09)%, (0.56 +/- 0.20)% respectively, P < 0.01, < 0.01, < 0.05, and < 0.01]. (4) The peri-tumoral LVA and intra-tumoral LVD and LVA in the patients with histological grade I, II, and III were (0.42 +/- 0.10)%, (9 +/- 3) vessels/mm(2), and (0.06 +/- 0.04)%; (0.77 +/- 0.37)%, (21 +/- 8) vessels/mm(2), and (0.21 +/- 0.09)%; and (0.83 +/- 0.46)%, (22 +/- 11) vessels/mm(2), and (0.21 +/- 0.12)% respectively. There were significant differences among the values of the grade II patients and grade I patients (all P < 0.05) and the grade III patients and grade I patients (all P < 0.05) and there were not significant differences between the values of the grade II patients and the grade III patients (all P > 0.05), III and grade I, no statistic significances between grade II and III. CONCLUSION: Higher lymphangiogenesis in early cervical squamous cell cancer may be associated with the risk of lymph node metastasis.
Keywords:Cervx neoplasms  Lymphatic system  Lymphatic metastasis
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