口腔粘膜疣状癌基膜的免疫组化和超微结构研究

目的 研究口腔粘膜疣状癌基膜Ⅳ型胶原与层粘连蛋白的表达、分布和超微结构改变。方法 采用免疫组化S－P法，分别检测16例疣状癌、10例鳞癌和9例中至重度不典型增生病例中Ⅳ型胶原与层粘连蛋白的表达，对表达结果作定量分析，并对3例疣状癌作电镜观察。结果 疣状癌基膜大多数较厚且保持完整（13／16），电镜下观察基板在一些区域明显增厚。但炎症细胞较多的病例，基膜出现中断（3／16）。鳞癌和中至重度不典型增生基膜相对较薄，鳞癌基膜绝大多数不连续（9／10），尤其在浸润的前沿或小条索状癌结构中，基膜基本中断或消失。中至重度不典型增生基膜大多数连续（6／9）。所有病例的癌巢周围间质中都可见炎症细胞浸润，疣状癌较鳞癌和中至重度不典型增生中浸润的淋巴细胞更为密集（P＜0．05）。在疣状癌中，上皮内炎症细胞浸润与其基膜完整呈正相关关系（P＜0．01）。结论 疣 状癌基膜较厚，较完整且结缔组织中有大量以淋巴细胞为主的炎症细胞浸润，可能与生物学行为有关。

Immunohistochemical and ultrastructural study of basement membrane in oral verrucous carcinoma

OBJECTIVE: To study the immunohistochemical alteration of basement membrane (BM) type IV collagen and laminin in oral verrucous carcinoma and its BM ultrastructural variations. METHODS: 16 cases of oral verrucous carcinoma (OVC), 10 cases of oral squamous cell carcinoma (OSCC) and 9 cases of oral mild to severe epithelial dysplasia (OMSD) were studied by using a immunohistochemical S-P method, and the results were analyzed by quantitative method. 3 cases of OVC were observed by TEM. RESULTS: The BM in OVC was thicker than in OSCC and OMSD. TEM found the basal lamina in some areas showed a marked reduplication. The BM in OVC was generally intact (13/16), whereas in OSCC it was mostly discontinuous (9/10), especially around the neoplasm front or the small cord consisted of a few cells, and mostly continuous in OMSD (6/9). There was a stromal inflammatory infiltration around tumor nests for all the oral lesions, but it was much heavier in OVC than that in OSCC and OMSD (P < 0.05). There was a positive correlation between intraepithelial lymphocytic infiltration and the BM continuity for OVC(P < 0.01). CONCLUSIONS: The more continuous BM and the heavier inflammatory infiltration in the connective tissue of OVC may be related to its biological behavior.