外阴营养不良、外阴鳞状上皮细胞癌凝集素标记免疫组化分析

目的：探讨外阴营养不良增生型，硬化苔藓型表皮细胞和外阴鳞状上皮细胞癌等细胞膜结构与凝集素受体结合表达特征及它们三者之间的关系。方法：对慢性外阴营养不良表皮增生型，苔藓硬化型及外阴鳞状上皮细胞癌3种状态下的细胞进行了8种凝集素免疫组织化学标记，分析，比较。结果：外阴营养不良增生型表皮各层细胞细胞膜与刀豆凝集素（ConA)，扁豆凝集素（LCA），花生凝集素（PNA），蓖麻凝集素（RCA－1）和大豆凝集素（SBA）结合强度弱，其表皮细胞细胞核膜与ConA,PNA和麦胚凝集素（WGA）有中等强度结合，外阴营养不良硬化苔藓型表皮各层细胞细胞膜与ConA,RCA-1 SBA和WGA结合强度弱，而与LCA不结合，其12例中的8例与荆豆凝集素（UEA－1）发生较弱的结合，外阴鳞状上皮细胞癌癌细胞与8种凝集素均结合，其12例中的7例其癌细胞膜与双花扁豆凝集素（DBA）弱结合，癌细胞膜与UEA－1强结合，但癌巢中央细胞团不与UEA－1结合，癌细胞细胞核膜与ConA,LCA,RCA-1呈强结合。结论：凝集素标记免疫组织化学染色可作为诊断，鉴别诊断外阴营养不良增生，硬化苔藓型和外阴鳞状上皮细胞癌新的指标，具有恶变潜能的增生型外阴营养不良与外阴鳞状上皮细胞癌，两者细胞核膜凝集素标记有相似之处，提示在外阴组织的癌变过程中，细胞核膜凝集素标记的异常表达是一个早期标识，糖基和糖蛋白代谢的异常可能是细胞发生癌变最早期的表现之一。

Immunohistochemical analysis of lectin binding in vulvar dystrophy and squamous cell carcinoma of the vulva

Purpose To explore the characteristics of the lectins binding in hyperplastic vulvar dystrophy and lichen sclerosis epidemis and vulvar squamous cell carcinoma. Methods Hyperplastic vulvar dystropy,lichen sclerosus and squamous carcinoma were labelled by eight lectins with the technique of immunohistochemistry.Results There was a weak labelling in cell membrane of the epidemis with hyperplastic vulvar dystrophy with concanavalin agglutinin (ConA),lens cuinars agglutinin(LCA), peanut agglutinin(PNA), rieinus communis agglutinin(RCA 1) and soybean agglutinin(SBA), an intermediate intensity of labelling was found in the nuclear membrane with ConA, PNA and wheat germ agglutinin(WGA). Cellular membrane of lichen sclerostic epidemis of vulvar dystrophy was weakly stained with ConA, RCA 1, SBA and WGA, but not LCA. Eight in 12 specimens were binded weakly with uiex europaeus agglutinin(UEA 1). All the 8 lectins were able to bind with vulvar squamous cell carcinoma(VSCC), in which 8 in 12 cases of VSCC were combined weakly with dolichos biflorus agglutinin(DBA). Intensive labelling appeared in the membrane of cancer cells with ConA, UEA 1, LCA and RCA 1, but epithelial pearls were negative for UEA 1.Conclusions Immunohistochemical staining of lectins can be used as a new marker in the diagnosis and differential diagnosis of vulvar dystrophy of hyperplastic and lichen sclerostic types, and squamous cell carcinoma. There is a similar lectin labelling pattern between hyperplastic vulvar dystrophy and vulvar squamous cell carcinoma, which suggests that abnormal lectin binding may be an early event in the vulvar carcinogenesis.