早期子宫颈癌中LYVE 1标记的淋巴管密度及其临床意义

目的探讨早期子宫颈癌组织中淋巴管内皮透明质酸受体 1（LYVE 1）标记的淋巴管密度（LVD）及其临床意义。方法采用免疫组织化学SP法检测41例早期子宫颈癌（Ⅰa Ⅱa）和12例正常子宫颈存档组织蜡块中LYVE 1标记的LVD，分析其与临床病理因素的关系。结果　①肿瘤组织周围淋巴管管腔扩大，形态不规则，肿瘤组织内部淋巴管管腔小，多呈闭塞状态。肿瘤组织内部淋巴管密度（ILVD）明显高于肿瘤组织周围淋巴管密度（PLVD）（P＜0.01）。ILVD和PLVD与正常子宫颈组织LVD相比均明显增加（P＜0.01）；②与无淋巴结转移者相比，有淋巴结转移者ILVD和PLVD均明显增加（P＜0.05，P＜0.01）。与无淋巴管浸润者相比，有淋巴管浸润者ILVD和PLVD均明显增加（P＜0.05，P＜0.01）。组织学分级G2、G3与G1相比，ILVD和PLVD均明显增高（P＜0.05），而G2、G3差异无统计学意义（P＞0.05）。结论早期子宫颈癌组织中ILVD和PLVD与正常子宫颈组织相比明显增加，并与淋巴结转移、淋巴管浸润等临床病理因素相关，肿瘤淋巴管生成可能在早期子宫颈癌淋巴转移过程中发挥了重要作用。

Clinical significance of lymphatic vessels density marked by LYVE-1 in the early-stage of invasive carcinoma of cervical uteri

To investigate the expression and its clinical significance of lymphatic vessels density (LVD) stained by lymphatic vessel endothelial hyaluronan receptor 1（LYVE 1）in the early stage of invasive carcinoma of cervical uteri. MethodsImmunohistochemical staining with LYVE 1 was used to determine LVD in 41 cases of early stage of invasive carcinoma of cervical uteri and 12 cases of normal cervical uteri, and their correlation with tumor clinicopathological features was analyzed. Results①The majority of peritumoral lymphatic vessels was often enlarged and irregular. In contrast, the intratumoral lymphatic vessels were small and collapsed. The peritumoral lymphatic vessels density (PLVD) was significantly higher than the intratumoral lymphatic vessels density (ILVD)(P＜0.01). Compared with the LVD of benign cervix, both ILVD and PLVD were more significantly increased (P＜0.01).②Both ILVD and PLVD in patients with lymph nodal metastasis were significantly higher than those without lymph nodal metastasis (P＜0.05, P＜0.01). The same happened in the relationship between lymphatic vessel invasion and ILVD or PLVD (P＜0.05, P＜0.01). Both ILVD and PLVD in patients with histological grade G2 and G3 were more significantly increased than G1 (P＜0.05), but there were no differences between G2 and G3 (P＞0.05). ConclusionCompared with the LVD of benign cervix, both ILVD and PLVD are significantly increased and correlated with lymph node metastasis and lymphatic vessel invasion. Tumor lymphangiogenesis in the early stage of invasive carcinoma of cervical uteri may play an important role in the process of lymphatic metastasis.