人结肠癌和胃癌淋巴管形态结构的研究

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 ,提示结肠癌和胃癌组织的淋巴道转移可能是通过癌组织周围区淋巴管内皮细胞连接的开放和癌组织对淋巴管内皮细胞的破坏溶解作用而进入淋巴管管腔的     

小鼠胃癌组织及淋巴管的光镜观察

目的观察小鼠胃癌组织及淋巴管的形态特征,为探讨胃癌淋巴道转移的特点和机制供形态学依据。方法苯并荜灌胃构建小鼠胃癌模型,24周摘取肿瘤,HE染色和LYVE-1免疫组化染色,观察癌组织及淋巴管的形态、分布特点。结果实验组24周时肿瘤发生率较高,癌肿直径不等,表面凸凹不平、质硬,成浸润性生长。光镜下以鳞癌多见,其次腺癌,癌细胞由黏膜层浸润至粘膜下层或肌层,少数到浆膜层。在癌周边区可见染成棕黄色扩张的毛细淋巴管和淋巴管,部分管壁被破坏,其内可见癌细胞和炎性细胞。胃癌组织内淋巴管的数量和管径均大于正常区。结论苯并荜灌胃诱发昆明小鼠胃癌为鳞癌或腺癌。胃癌组织内淋巴管的数量和管径均大于正常区,为癌细胞淋巴道转移提供了更多机会。     

人胃癌淋巴管的超微结构

目的研究人胃癌组织毛细淋巴管的超微结构特点,探讨癌细胞淋巴道转移机理。方法取人胃癌中心区、周边区及正常区组织块,常规制作,树脂包埋,半薄切片,光镜下定位、检出淋巴管经超薄切片,电镜观察。结果胃癌中心区未见淋巴管。胃癌周边区较正常区毛细淋巴管数量多,管腔较大,形态不规则;毛细淋巴管内皮细胞破坏,细胞器有明显改变。正常区毛细淋巴管的分布和形态结构未见明显变化。结论人胃癌周边区淋巴管的数量、形态及超微结构均有变化;胃癌细胞进入淋巴管的主要途径可能是经内皮细胞破坏处和连接开放处。     

胃癌癌周淋巴管的结构

本文应用光、电镜方法研究胃癌癌周淋巴管的结构特点,结果发现癌周淋巴管的内皮细胞间的开放连接增加;重叠连接、插入连接可转变为开放连接．癌细胞浸润毛细淋巴管壁,并进入淋巴管腔,在癌细胞侵润区,淋巴管内皮细胞明显变性、溶解、破损。     

人胃癌组织淋巴管的超微结构及其与淋巴转移的关系

目的研究人胃癌组织淋巴管的超微结构特点,探讨胃癌淋巴转移机制。方法取人胃癌中心区、周边区及正常区组织块,常规固定,树脂包埋,半薄切片,光镜下定位,检出淋巴管经超薄切片,透射电镜观察。结果人胃癌中心区未见淋巴管;胃癌周边区较正常区淋巴管增多(t=3.270,P=0.002),管腔较小(t=-5.315,P=0.000),开放连接增多(χ2=12.895,P=0.000),淋巴管破坏增多(χ2=15.674,P=0.000);淋巴转移组胃癌周边区比无淋巴转移组胃癌周边区淋巴管多(t=2.523,P=0.021),被破坏的淋巴管多(χ2=5.281,P=0.022),开放连接/非开放连接数差异无统计学意义(χ2=0.217,P=0.641)。结论人胃癌周边区存在淋巴管新生;胃癌细胞可能是通过胃癌周边区被破坏的淋巴管进行转移的。     

人胃癌淋巴管密度和面积及其与淋巴结转移的关系

目的研究人胃癌淋巴管的密度和面积及其与淋巴结转移的关系。方法采用D2-40淋巴管内皮标记性抗体免疫组织化学染色方法,检测70例人胃癌中心区、癌旁区、正常区内的淋巴管,分析淋巴管的形态学特征与淋巴结转移及其他临床病理因素之间的关系。结果人胃癌癌旁区淋巴管密度高于正常区,平均面积、平均周径及总面积小于正常区,差异均有统计学意义。淋巴结转移组人胃癌癌旁区淋巴管密度及平均面积、平均周径均高于无淋巴结转移组。结论人胃癌淋巴管新生存在于胃癌癌旁区,新生淋巴管管腔小,不足以形成良好的淋巴回流;人胃癌癌旁区淋巴管密度、平均面积与淋巴结转移有关,有望成为预测淋巴结转移及决定手术方式的重要因素。     

人胰腺癌淋巴管的分布及形态观察

目的观察人胰腺癌淋巴管的分布及形态结构,探讨胰腺癌淋巴道转移机制。方法取手术后人胰腺癌标本21例,应用免疫组化染色法LYVE-1标记淋巴管进行淋巴管计数,半薄切片光镜观察和超薄切片透射电镜观察胰腺癌组织淋巴管的形态及分布特点。结果胰腺癌组织中LYVE-1染色阳性的脉管具有淋巴管的形态学特征,可见癌周组织的微淋巴管数量较癌旁"正常区"有所增加(P<0.01);半薄切片光镜下可见癌周边区和"正常区"淋巴管存在,癌中心区未见有淋巴管;电镜下癌周边区淋巴管内皮细胞连接开放,部分内皮细胞破裂溶解,管壁不完整。淋巴管内皮细胞的线粒体、高尔基体等细胞器改变。结论胰腺癌组织淋巴管主要位于癌周围浸润区的纤维结缔组织中,且淋巴管数量较癌旁"正常区"增多,淋巴管内皮超微结构改变。胰腺癌淋巴管转移可能通过增多的淋巴管的内皮连接开放和对内皮细胞的破坏溶解作用进入淋巴管管壁。     

胃癌组织内淋巴管的形态计量学研究

目的；研究胃癌细胞淋巴道转移机理，方法用图像分析仪测定３２例胃癌组织及癌旁组织内有腔淋巴管和毛细淋巴管最大面积，周径和管径。结果：在胃癌组织内以条索状毛细淋巴管为多，而在癌旁组织内则以开放的淋巴管和毛细淋巴管为主，图像分析结果表明，转移组胃癌组织与癌旁组织内淋巴和和毛细淋巴管腔面积，周径和管径，两者间彼此差异均有显著性（Ｐ〈０．０５）；未转移胃癌组织与癌旁组织内淋巴管和毛细淋巴管腔面积，周径和管径     

人直肠癌组织淋巴管的微细分布

目的研究人直肠癌淋巴管的微细分布和结构特征,为进一步探讨癌组织的淋巴道转移机理提供形态学依据。方法取直肠癌手术切除的组织,按不同部位取材,812树脂包埋,半薄切片光镜观察淋巴管的形态及结构特征。结果在癌中心区未见淋巴管,癌周围区的淋巴管密度较正常区增多,直肠癌周边区淋巴管的体密度和数密度均明显高于正常区(P<0.05,P<0.01)且管腔扩张,管壁常见到溶解、破坏,并见癌细胞团靠近扩张的毛细淋巴管。结论癌周围区的淋巴管有数量及形态结构的改变,增加了癌细胞淋巴道转移的机会。直肠癌的淋巴道转移可能以溶解、破坏淋巴管壁而进入淋巴管为主要途径。     

大鼠胃壁淋巴管形态分布的实验研究

本文用光镜和透射电镜观察了饱食与饥饿状态下大鼠胃壁淋巴管的微细分布、出现率和形态结构的特点，结果表明：两组大鼠胃壁内淋巴管的出现率及在各层内的分布均无显著差异。粘膜层仅见毛细淋巴管，其它各层可见毛细淋巴管和淋巴管。光镜下饱食鼠胃壁内毛细淋巴管和淋巴管的管腔较大且饱满，而饥饿鼠相同区域的毛细淋巴管和淋巴管的管腔较小，形态更加不规则。电镜下也可见到饱食鼠毛细淋巴管的管壁较平整，皱褶与质膜突起较少，而饥饿鼠毛细淋巴管壁较厚，皱褶和质膜突起较多。     

人乳腺癌组织淋巴管的超微结构

目的 观察人乳腺癌组织毛细淋巴管的超微结构特点,探讨乳腺癌细胞淋巴道转移机理.方法 取20例人乳腺癌术后标本,按癌中心区、周边区及正常区切取组织,半薄切片,光镜定位,透射电镜观察乳腺癌组织毛细淋巴管超微结构.结果 乳腺癌组织中心区未见淋巴管,癌周边区和正常区组织内存在毛细淋巴管.与正常区比较,周边区组织内淋巴管数量增多,管腔扩大,形态不规则;淋巴管内皮细胞连接开放增多,并可见部分内皮细胞破裂溶解,管壁不完整;毛细淋巴管内皮细胞变性,高尔基体变形,粗面内质网脱颗粒,溶酶体数量增多和形态改变.结论 乳腺癌周边区组织内毛细淋巴管内皮细胞的超微结构有改变,提示癌细胞对内皮细胞有破坏、溶解作用;癌细胞可能以通过癌周边区毛细淋巴管内皮细胞连接的开放和毛细淋巴管内皮破坏两种方式侵袭淋巴管而发生淋巴道转移.     

Intratumoral Lymphatics and Lymphatic Vessel Invasion Detected by D2‐40 Are Essential for Lymph Node Metastasis in Bladder Transitional Cell Carcinoma

Bladder cancer is frequently associated with regional lymph node metastasis at the time of diagnosis or after initial treatment, and lymph node metastasis is crucial for clinical therapeutic strategies. Lymphangiogenesis, detected by antibodies specific for lymphatic endothelial cells, is correlated with cancer spread, but the mechanisms that underlie lymphatic spread and the role of lymphangiogenesis in cancer metastasis has been less clear. The aim of this study was to investigate the association of vascular endothelial growth factor (VEGF)‐D expression, intratumoral lymphatics, and lymphatic invasion associated with lymph node metastasis as well as the prognostic analysis in patients with bladder transitional cell carcinoma (TCC). The VEGF‐D expression was evaluated by immunohistochemistry in 72 specimens, and tumoral lymphatic vessels were measured by D2‐40. Counts of lymph vessels were taken in intratumoral and peritumoral areas. Survival analyses and their independent roles were investigated using univariate and multivariate analysis models. The high expression of VEGF‐D was closely associated with the intratumoral lymphatic vessels, tumoral lymphatic invasion, and lymph node metastasis as well as a shorter overall survival. Higher lymphatic vessel density, intratumoral lymphatics, and lymphatic invasion showed a significant association with lymph node metastasis. Univariate analysis indicated that VEGF‐D, intratumoral lymphatics, and lymphatic invasion were associated with overall survival, but they were not independent prognostic factors for bladder TCC in multivariate analysis. We conclude that VEGF‐D plays an essential role in tumoral lymphangiogenesis. Intratumoral lymphatics and lymphatic invasion are important predictive factors of pelvic lymph node metastasis in patients with bladder cancer. Anat Rec, 2010. © 2010 Wiley‐Liss, Inc.     

胃癌的浆膜下淋巴道转移

在8例不同浸润生长方式的进展期胃癌标本的全剥浆膜的节段性连续切片进行了组织病理学观察。看到胃癌细胞在胃壁淋巴管内的转移方式有二:即连续性癌栓及漂浮性癌。不同的转移癌方式与胃癌癌肿本身的浸润生长方式有关,巢状及团块状生长的胃癌多呈连续性癌栓转移,而弥漫性生长的胃癌多呈漂浮性癌栓转移。     

胆碱能神经在正常人胃壁的分布

为了给临床病理状态下胃溃疡神经分布提供参照，更好地为溃疡病的防治提供形态学依据，本文采用Ｋａｒｎｏｖｓｋｙ－Ｒｏｏｔｓ法，观察了４例正常人胃壁胆碱能神经纤维分布特点。结果：胃壁各层均有乙酰胆碱酯酶（ＡＣｈＥ）阳性纤维，但上皮和固有层上部未见ＡＣｈＥ阳性纤维；ＡＣｈＥ阳性纤维有４种形态：终末纤维、终末前纤维、神经束、神经干，胃壁各层细小动脉壁也存在神经末梢分布，在含非特异胆碱酸酶反应中，可见胃粘膜上皮下固有膜内，存在分支的神经末梢交互联成网状，可能是传入性质，对其功能意义做了讨论     

Granulomatous Inflammatory Reaction in Human Gastric Adenocarcinomas: A Light and Electron Microscopy Study

ABSTRACT

Granuloma is a focal, compact collection of inflammatory cells in which mononuclear phagocytes predominate. The authors report 9 cases of papillary—tubular gastric adenocarcinomas characterized by mature granulomas associated with recent microhemorrhages. Mature granulomas were composed of foamy, CD68-positive histiocytes with occasional giant cells. Hemosiderin-containing macrophages were present in the tumor stroma, suggesting phagocytosis of erythrocytes. Under electron microscopy, mature (nonepithelioid) granulomas and clusters containing 1 macrophage and 1–3 eosinophils were found. This study provides morphological examples of skewed type II macrophage infiltration in gastric adenocarcinomas that is involved in scavenging activity, particularly erythrophagocytosis, formation of mature (nonepithelioid granulomas), and heterotypic aggregation with eosinophils.     

胃癌雌激素受体的组化法定量分析与半定量分析及DCC法的比较

本文以酶联雌二醇亲和组化法(E_2—HRP法)检测57例胃癌的雌激素受体(ER),并在光镜下判断阳性细胞百分率和阳性强度。为了消除这种半定量分析中的人为误差,所有阳性病例均用图像分析仪进行细胞化学定量分析,将观察ER阳性细胞的组织学分布与确定其含量结合起来,分别测得ER阳性细胞百分率和ER阳性强度,再算出ER水平指数,并将其结果与肉眼的半定量分析及葡聚糖包裹活性炭法(DCC法)的结果作了比较和讨论。     

A New Technique to Map the Lymphatic Distribution and Alignment of the Penis

The present study was to examine the distribution of lymphatic vessels in the penis of normal adult males, which could provide an anatomical basis for improvement of incisions in penile lengthening surgery, and may also help to prevent postoperative refractory edema. Thirteen normal adult male volunteers were recruited for this study. Contrast agent was injected subcutaneously in the foreskin of the penis, and after two minutes magnetic resonance lymphangiography (MRL) was performed. The acquired magnetic resonance images were analyzed to determine the changes in the number and diameter of lymphatic vessels in different parts of the penis. Maximum intensity projections (MIP) and materializes interactive medical image control system (MIMICS) were applied to analyze the overall distribution of lymphatic vessels in the penis. Magnetic resonance imaging (MRI) showed that the lymphatic vessels were in conspicuous contrast with surrounding tissues and could be clearly identified. Penile lymphatic vessels were clearly visible in the root of the penis. At the junction of the penis and the abdominal wall, all lymphatic vessels were found to be concentrated in the dorsal part of the penis. MIP two‐dimensional reconstruction showed that the overall distribution of relatively large lymphatic vessels in the dorsal and ventral parts of the penis could be seen clearly on bilateral 45° position, but not inside the abdominal wall because some of lymphatic vessels were overlapped by other tissues in the abdomen. MIMICS three‐dimensional reconstruction was able to reveal the overall spatial distribution of lymphatic vessels in the penis from any angle. The reconstruction results showed that there were 1–2 main lymphatic vessels on the root of dorsal penis, which coursed along the cavernous to the first physiological curvature of the penis. Lymphatic vessels merged on both sides of the ventral penis. At the root of the penis, lymphatic vessels gradually coursed to the dorsal surface of the penis and folded at the abdominal wall to the outside, and finally merged into the inguinal lymph nodes. The changes in distribution, number and diameter of the lymphatic vessels in the penis were observed by MRI. MIP and MIMICS reconstructions directly revealed the anatomical features of penile lymphatic vessels such as spatial distribution, overall alignment, and the relations to adjacent structures, drainage and reflux. The study will provide the anatomical basis for penile surgery, penile lymphatic reflux disorders caused by trauma or lymphatic vessels obstruction, and lymph node metastasis in penile cancer. Anat Rec, 298:1465–1471, 2015. © 2014 Wiley Periodicals, Inc.     

人外周血淋巴细胞酶活性光镜细胞化学定位

目的　探讨人外周血淋巴细胞酶结构定位与活性。方法　应用光镜酶细胞化学方法对人外周血淋巴细胞ATP酶与G 6 P酶进行酶的定位与活性分析。结果　ATP酶阳性反应颗粒清晰 ,见于淋巴细胞膜内侧 ,G 6 P酶阳性反应颗粒见于淋巴细胞胞质内。结论　二种酶存在于人淋巴细胞内。     

胃癌间质肥大细胞及其与癌恶性程度关系的研究

取胃癌手术标本40例,经10%甲醛固定,甲苯胺蓝、Alcian蓝—藏红和GABE液染色,研究胃癌间质肥大细胞计数与癌恶性程度之间的关系。结果表明:胃癌间质肥大细胞的计数与胃癌恶性程度密切相关。恶性程度低组的肥大细胞计数显著高于恶性程度高组(P<0.005)。Alcian蓝—藏红(Csaba法)染色24h,能较好地显示胃癌间质肥大细胞。本文还就上述结果的意义进行了讨论。