细胞外基质抗原在声门上型喉鳞癌中表达的意义

目的：探讨细胞外基质（ECM）抗原的表达及其在声门上型喉鳞癌中的屏障意义。方法：分别应用抗Ⅳ型胶原纤维（CTⅣ）单克隆抗体、抗层粘连蛋白（LN）单克隆抗体、抗纤维连接蛋白（FN）单克隆抗体以链霉素亲生物素－过氧化酶免疫组化法观察这3种抗原在声门上型喉鳞癌中的表达分布情况，以评价ECM包绕癌巢的完整性与肿瘤细胞分化程度、浸润方式及颈淋巴结转移的关系。结果：在低分化和肿瘤弥散浸润的喉鳞癌组织中，3种抗原表达缺人率明显高于分化良好及肿瘤边界良好的组织（P＜0．01）。3种抗原表达缺失者发生颈淋巴结转移率高于表达完整者，二者之间有较强相关性（P＜0．01）。结论：ECM 3种抗原表达的完整性可以用来评价声门上型喉鳞癌细胞分化程度及喉鳞癌组织浸润能力，也可作为预测声门上型喉鳞癌发生颈淋巴结转移的重要参数之一。

The expression of extracellular matrix in squamous cell carcinoma of the larynx: An immunohistochemical study

OBJECTIVE: To investigate the expression and the protective significance of extracellular matrix (ECM) in laryngeal squamous cell carcinomas(LSCC). METHOD: The expression and distribution of three antigens, human type IV collagen(CT IV), laminin(LN) and fibronectin(FN) were immunohistochemically determined in 72 cases of LSCC by using the corresponding monoclonal antibodies. The correlation of the intact continuance of ECM around the tumor nest with the cell differentiation, invasion mode and the regional lymph node metastasis of laryngeal squamous cell carcinoma was evaluated. RESULT: In cases with poor histological differentiation, the defect of ECM was more severe than that in cases with high or middle histological differentiation(P < 0.01). Moreover, cases with diffuse invasion revealed lower ECM expression compared with cases with better tumor-host border (P < 0.01). There was a higher risk of regional lymph node metastasis among cases with poor ECM expression (P < 0.01). And there was a significant association between the defect of ECM and the lymph node metastasis(P < 0.01). CONCLUSION: These observations indicates that testing the distribution and the expression of ECM seems to be useful to evaluate the histological grading of malignancy and the invasion mode of laryngeal squamous cell carcinoma and to be helpful to prognosticate the frequency of regional lymph node metastasis.