宫颈鳞状细胞癌局部淋巴管生成及浸润转移及预后关系.docVIP

宫颈鳞状细胞癌局部淋巴管生成及浸润转移及预后关系 　 作者：林岷, 江忠清, 连成瑛, 郑秀, 吴桂珠, 曾赛凡 【摘要】 目的 探讨宫颈鳞状细胞癌（SCC）局部淋巴管生成与临床病理特征及预后的关系。 方法 采用免疫组织化学SP法检测28例正常宫颈上皮(NCE)、36例宫颈上皮内瘤变(CIN)和68例SCC中血管内皮生长因子受体(VEGFR)-3、微淋巴管密度(LMVD)、Ki-67增殖指数(PI)和CD34微血管密度(MVD)。 结果 LMVD在NCE、CIN及SCC组分别为(2.24±3.82),(6.37±5.69)和(8.29±2.80)。从NCE,CIN到SCC,LMVD显著升高(Plt;0.01)。SCC组LMVD与盆腔淋巴结转移、间质浸润及预后密切相关(Plt;0.05),与年龄、FIGO分期、组织学分级、脉管浸润、PI及MVD无显著相关(Pgt;0.05)。SCC有盆腔淋巴结转移及突破深肌层间质浸润者,其LMVD分别显著高于无盆腔淋巴结转移及未突破深肌层间质浸润者(Plt;0.05)。高LMVD的SCC患者生存率显著低于低LMVD者(Plt;0.001)。 结论 SCC局部LMVD升高可能预示肿瘤进展及不良预后。 【关键词】 宫颈肿瘤,病理学; 微淋巴管密度; 血管内皮生长因子受体-3; 转移; 预后; 免疫组织化学 ABSTRACT: Objective To investigate the association of regional lymphangiogenesis and clinico-pathologic characteristics and prognosis in cervical squamous cell carcinoma. Methods The lymphatic microvessel density(LMVD) labeled by vascular endothelial growth factor receptor-3（VEGFR-3）, proliferation index(PI) of cancer cells labeled by ki-67 and microvessel density(MVD) labeled by CD34 in 28 cases of normal cervical epithelium(NCE), 36 cases of cervical intraepithelial neoplasm(CIN) and 68 cases of squamous cell carcinoma of cervix(SCC) were detected by immunohistochemistry SP method. Results The LMVD in NCE, CIN and SCC group were (2.24±3.82), (6.37±5.69) and (8.29±2.80), respectively. The LMVD increased remarkably from NCE to CIN and SCC accordingly(Plt;0.01). In SCC, the LMVD correlated with pelvic lymph node metastasis, stroma involvement and prognosis(Plt;0.05), but not correlated with patient’s age, FIGO staging, histological grading, intravascular infiltration, PI and MVD(Pgt;0.05). In the cases with pelvic lymph node metastasis and deeper stroma involvement, the LMVD were significantly higher than that in those without the conditions mentioned above(Plt;0.05). The patients with higher LMVD in SCC had significantly lower survival rate than that in those with the lower LMVD(P=0.001). Conclusion The higher LMVD in SCC may predict cancer progression and bad prognosis. KEY WORDS: cervical neoplas