大肠癌组织淋巴管分布特点及其与转移和预后的关系

目的探讨大肠癌组织淋巴管分布特点及其与转移和预后的关系.方法采用抗淋巴管特异抗体podoplanin对96例大肠癌及其相应正常黏膜进行免疫组化染色,并结合临床病理参数及预后分析.结果大肠癌中心及浅表部淋巴管多为闭锁的条索状,边缘区淋巴管多呈管样扩张状,癌组织总平均MLD值与正常大肠MLD均值间无显著性差异(P>0.05),肿瘤边缘MLD均值较正常大肠组织非常显著性增高(P<0.01),而肿瘤中心区MLD均值显著低于正常组织(P<0.01),肿瘤浅表区MLD均值与正常组织差异不显著(P>0.05).伴淋巴管受累、淋巴结和远处转移组大肠癌,其边缘区MLD较无淋巴管受累、无淋巴结和远处转移组均显著增高(P<0.01).大肠癌边缘区高MLD组5年生存率显著低于低MLD组(P<0.05).结论大肠癌组织中淋巴管主要分布在肿瘤边缘区,癌周围淋巴管密度增加与癌细胞转移相关,大肠癌边缘区MLD测定对判断其转移可能具有意义,且大肠癌周MLD检测对大肠癌预后判断具有参考价值.

The distribution characteristic of lymph vessel in colorectal carcinoma tissue and its relationship to metastasis and prognosis

Objective To explore the distribution characteristics of lymph vessel in colorectal carcinomas(CRCs) and the relationship of microlymphatic density(MLD) to metastasis and prognosis.Methods The lymph vessels in 96 cases of CRCs and matched normal mucosa were quantitated by immunostaining for special lymphatic endothelial marker podoplanin,and the correlations of lymph vessel density with clinical and pathological variables were evaluated.Results The lymph vessels at central and superficia1 regions in CRCs often had a reticular architecture with numerous tiny or ill-defined lumina,the lymph vessels at the tumor~()margin had a conventional architecture with large open lumina.The total MLD values of CRCs and the MLD values at superficia1 regions were of no significant difference compared with that of normal mucosa(P>0.05),but the MLD values at the tumor margin were significantly higher than that of normal mucosa(P<0.01),the MLD values at central regions were significantly lower than that of normal mucosa(P<0.01).The MLD values were significantly different between the CRCs with and without lymphatic involvement,lymph node metastasis and distant metastasis(P<0.01).The 5-year survival rate was significantly lower in the patients with high MLD than in those with low MLD(P<0.05).Conclusion The lymph vessels were mainly distributed at the tumor~()margin in CRCs,and the high MLD peritumoral regions was associated with metastasis. The detection of MLD at the tumor margin may be useful to predict metastasis and prognosis of colorectal carcinoma.