乳腺癌组织中微淋巴管分布及密度的临床病理意义论文.docxVIP

乳腺癌组织中微淋巴管分布及密度的临床病理意义 作者：张宇 宋吉宁 周为 黎卫平 马岚 【摘要】 目的 探讨乳腺癌组织中微淋巴管分布、密度及其与相关临床病理因素之间的关系, 分析乳腺癌淋巴结转移的可能机制。方法 应用免疫组化SABC法检测50例乳腺癌及其相应癌旁正常乳腺组织中D2-40的表达，并分别计数其微淋巴管密度（microlymphatic density，MLD）。结果 乳腺癌组织中的MLD明显高于癌旁正常组织(P)；肿瘤边缘区MLD与乳腺癌的临床分期、淋巴结转移状态相关(P)。结论 1)乳腺癌组织中存在淋巴管，且分布存在异质性，淋巴管主要分布于肿瘤边缘区，肿瘤边缘区MLD与淋巴结转移、临床分期状态相关，其MLD的增加可能与乳腺癌的侵袭及转移相关；2)乳腺癌组织中的MLD检测可作为评估乳腺癌淋巴结转移状况的一项辅助指标，为判断乳腺癌患者预后及确定临床治疗方案提供实验和理论依据。 【关键词】 乳腺癌 D2-40 MLD 淋巴结转移 免疫组织化学 Abstract Objective To investigate the characteristics of distribution and density of lymphatic vessel and the correlation with its clinicopathological factors in breast cancer and analyse the possible mechanism of lymph node metastasis in breast carcinoma. Methods Making use of immunohistochemistry to research the expression of D2-40 in 50 cases of breast carcinoma and the normal tissues near the tumor borderline,which microlymphatic density was counted. Results The MLD in breast carcinoma was significant higher than that in the normal tissue adjacent carcinoma(P). The MLD in the borderline had positive relation to the clinical stage, and lymph node metastasis (P). Conclusions 1. The lymphatic vessel appears in the breast carcinoma. It mainly distributes in the tumor borderline. The MLD in the tumor borderline has correlation with clinical stage ,lymph node metastasis. The increase of MLD may be related to the invasion and metastasis of breast carcinoma in the tumor The detection of MLD in the tissue of breast carcinoma can be a important affiliated markers to evaluate the lymph node metastasis. It also can measure the prognosis of breast carcinoma and provide experimental and theoretical foundation to confirm the clinical treatment methods. Key words Breast carcinoma D2-40 Microlymphatic density Lymph node metastasis Immunohistochemistry 肿瘤细胞经淋巴道转移是人体上皮源性恶性肿瘤的早期扩散主要途径之一。但由于缺乏淋巴管特异性标记物，对肿瘤淋巴管转移的研究相对滞后。肿瘤内是否存在淋巴管，肿瘤内淋巴管生成是否与淋巴道扩散转移有关？目前对此存在争议［1,2］。乳腺癌局部淋巴结转移十分常见，是影响预后的关键因素之一，一旦出现淋巴结转移，其患者生存率明显降低。为此本实验选取50例乳腺癌及其相应癌旁正常乳