淋巴管密度在甲状腺乳头状癌和滤泡癌的表达及意义

目的]探讨淋巴管密度（LVD）在甲状腺乳头状癌（PTC）和滤泡癌的表达及意义。方法]采用免疫组化技术,以D2-40标记淋巴管内皮,CD31标记血管内皮,对105例PTC、18例甲状腺滤泡癌和21例滤泡性腺瘤进行LVD和微血管密度（MVD）的检测。对LVD与乳头状癌的临床病理资料的关系,及乳头状癌和滤泡癌中MVD和LVD的表达差异进行了统计分析。结果]（1）PTC中均可见D2-40阳性淋巴管,其瘤周LVD较瘤内为高,淋巴结转移组（瘤内6.80±4.40;瘤周13.63±5.09）较无转移组（瘤内4.30±3.06;瘤周10.17±4.53）为高,两组比较有统计学差异（P〈0.01）。（2）甲状腺乳头状癌的瘤内LVD与TNM分期有关,高分期组（Ⅲ期/Ⅳ期）的瘤内LVD（7.33±4.79）较低分期组（Ⅰ期/Ⅱ期,5.16±3.71）为高,两者相比有统计学差异（P〈0.05）。（3）甲状腺乳头状癌的瘤内LVD（5.47±3.93）较滤泡癌的瘤内LVD（1.56±1.92）为高,两者相比,差异具有统计学意义（P〈0.05）。结论]甲状腺乳头状癌LVD与淋巴结转移密切相关,瘤周淋巴管的扩张形态和相对较高的LVD在甲状腺乳头状癌淋巴道转移中可能发挥了重要的作用。

Lymphatic Vascular Density in Papillary Carcinoma and Follicular Carcinoma of the Thyroid and Its Significance

Purpose]To investigate the expression and significance of lymphatic vessel density （LVD） in papillary carcinoma and follicular carcinoma of the thyroid. Methods] Immunohistochemistry with D2-40 as specific immunomarker of lymphatic vessel and CD31 as specific immunomarker of microvessel was used to detect LVD and microvessel density （MVD） in 105 cases with papillary thyroid carcinoma （PTC）, 18 cases with follicular carcinoma and 21 cases with follicular adenoma. The relationship between LVD and clinicopathologic variables of PTC, as well as differences of LVD and MVD between PTC and follicular carcinoma was investigated. Results] （1） D2-40-positive vessels were present in all papillary thyroid carcinoma. LVD of peritumor area of PTC was higher than that of intratumor region. LVD of PTC with lymphatic metastasis （6.80±4.40 in intratumor region; 13.63±5.09 in peritumor area） was higher than that of PTC without lymphatic metastasis （4.30±3.06 in intratumor region; 10.17±4.53 in peritumor area）, with statistical significance（P〈0.01）. （2）LVD of intratumor area of PTC was associated with TNM stage of PTC. LVD in intratumor area of PTC with high stage （stageIII and IV, 7.33±4.79） was higher than that with low stage （stage I and II ,5.16±3.71）, with statistical significance （P〈0.05）. （3） LVD in intratumor area of PTC （5.47±3.93） was higher than that of follicular carcinoma （1.56±1.92）, with statistical significance （P〈0.05）. Conclusions] LVD of PTC is closely related with lymphatic metastasis, the dilated lymphatic vessels and relatively high LVD of the peritumor area may be act an important role in lymphatic metastasis of PTC.