Dukes'B期直肠癌微淋巴管密度检测及其临床意义

背景与目的:Dukes)B期直肠癌患者预后差异大,临床未见淋巴结转移者可能有淋巴管微转移。本研究探讨Dukes)B期直肠癌微淋巴管密度(lymphaticvesseldensity,LVD)与预后的关系。方法:采用免疫组织化学方法标记淋巴管内皮特异性的淋巴管内皮细胞透明质烷受体-1(lymphaticvesselendothelialhyaluronanreceptor-1,LYVE-1),检测54例临床随访资料完整的Dukes)B期直肠癌患者癌组织、癌旁组织及正常肠组织的微淋巴管密度(200倍视野下微淋巴管数)。结果:54例中有11例(20.4%)癌组织、癌旁组织及正常肠组织中均未见LYVE-1阳性的棕黄染淋巴管,其余43例(79.6%)可见LYVE-1阳性的淋巴管。癌旁组织的微淋巴管密度(6.05±5.61)明显高于癌组织(0.89±0.66)(P<0.05)及正常肠组织(4.11±3.29)(P<0.05)。癌组织内的微淋巴管数目少,微淋巴管密度明显低于正常组织(P<0.05)。54例Dukes)B期直肠癌患者高淋巴管密度组(≥6)和低微淋巴管密度组(<6)患者复发、死亡等预后因素未见显著性差异(P>0.05)。结论:癌旁组织可能存在新生淋巴管生成,癌巢间隙的微淋巴管数目少。单纯通过微淋巴管密度的高低可能不足以评价Dukes)B期直肠癌患者的预后。

Lymphatic vessel density in Dukes' B rectal carcinoma and its correlation to prognosis

BACKGROUND & OBJECTIVE: The prognosis of patients diagnosed with Dukes' B rectal carcinoma varies largely. Micrometastasis via lymphatic vessel may have occurred in Dukes' B rectal carcinoma although no clinical pathologic evidence of lymph node metastasis was found. This study was to investigate the correlation of lymphatic vessel density (LVD) to the prognosis of Dukes' B rectal carcinoma. METHODS: Immunohistochemistry was used to display the lymphatic vessels with lymphatic endothelium-specific marker, lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1), in 54 specimens from Dukes' B rectal carcinoma. LVD in tumor, peri-tumor and normal tissues was calculated. All patients had complete clinical and follow-up data. RESULTS: Of the 54 specimens, 11 (20.4%) were LYVE-1-negative in tumor, peri-tumor, and normal tissues, 43 (79.6%) were LYVE-1-positive. LVD was significantly higher in peri-tumor than in tumor and normal tissues (6.05+/-5.61 vs. 0.89+/-0.66 and 4.11+/-3.29, P<0.05), and was significantly lower in tumor than in normal tissues (P<0.05). No significant correlation was found between LVD and recurrence rate (P>0.05), or overall survival (P>0.05). CONCLUSIONS: Lymphangiogenesis may occur in peri-tumor tissues. LVD may not be a prognostic factor of Dukes' B rectal carcinoma.