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背景与目的:关于淋巴转移机制,大多数研究局限于淋巴管的分布。本研究的目的是观察在癌组织周边区的淋巴管形态、分布和淋巴管内皮细胞的变化。方法:取人胃癌、大肠癌手术标本各10例,制作大鼠结肠癌模型20例。在光镜下观察淋巴管形态及其内皮细胞的超微结构。使用图像分析仪,测量癌组织周边区和正常区淋巴管的数密度和体密度,计算淋巴管开放率和破坏率。结果:癌周边区的淋巴管管腔扩张、管壁被破坏;淋巴管内皮细胞被溶解破坏,遗留断裂的碎片,细胞器出现病理变化。癌周边区淋巴管的密度高于正常区。人结肠癌癌周边区和正常区的淋巴管数密度分别为(10.2±1.7)/mm2和(5.1±0.8)/mm2(P<0.05),体密度分别为(1.5±0.2)%和(0.7±0.0)%(P<0.05)。人胃癌癌周边区和正常区的淋巴管数密度分别为(8.0±0.9)/m m 2和(3.4±0.6)/m m 2 (P <0.01),体密度分别为(1.6±0.3)%和(0.8±0.2)%(P <0.05)。鼠结肠癌模型、人胃癌和结肠癌的癌周边区淋巴管开放率(22.2%、35.0%、25.8%)明显高于正常区(7.8%、8.0%、5.0%)(P <0.05)。鼠结肠癌模型和人胃癌的癌周边区淋巴管破坏率(20.1%和35.3%)也明显高于正常区(0和2.0%)(P <0.05)。结论:与正常组织比较,癌组织周边区淋巴管管腔扩张,管壁破坏,内皮细胞被溶解破坏,淋巴管密度增大。
Background and Objectives: Most studies are limited to the distribution of lymphatic vessels with regard to lymphatic metastasis. The purpose of this study was to observe the changes of lymphatic vessel morphology, distribution and lymphatic endothelial cells in the peripheral region of cancer tissue. Methods: Ten cases of gastric cancer and colorectal cancer were collected, and 20 cases of rat colon cancer model were made. The morphology of lymphatic vessels and the ultrastructure of endothelial cells were observed under light microscope. Using image analyzer, the number density and body density of lymphatic vessels in the peripheral area and the normal area of cancer tissue were measured, and the open rate and the destruction rate of lymphatic vessels were calculated. Results: The lymphatic lumen in the peripheral area of the carcinoma was expanded and the wall of the lymphatic vessel was destroyed. The lymphatic endothelial cells were dissolved and destroyed, and fragments of the ruptured organelles appeared pathological changes. Peripheral lymphatic vessels density is higher than normal. The numbers of lymphatic vessels in peripheral and normal areas of human colon cancer were (10.2 ± 1.7) / mm2 and (5.1 ± 0.8) / mm2 respectively (P <0.05), and the body densities were (1.5 ± 0.2)% and ± 0.0)% (P <0.05). The numbers of lymphatic vessels in peripheral and normal human gastric cancer tissues were (8.0 ± 0.9) / mm 2 and (3.4 ± 0.6) / mm 2 respectively (P <0.01), and the body densities were (1.6 ± 0.3)% and 0.8 ± 0.2)% (P <0.05). The open rate of lymphatic vessels in the peripheral area of the mouse colon cancer model, human gastric cancer and colon cancer was significantly higher than that in the normal area (7.8%, 8.0%, 5.0%, P <0.05). The rate of lymphatic vessel destruction (20.1% and 35.3%) in the murine colon cancer model and human gastric cancer was also significantly higher than that in the normal (0 and 2.0%) (P <0.05). Conclusion: Compared with normal tissues, the lymphatic vessels in the peripheral region of the cancer tissue are dilated, the wall is destroyed, the endothelial cells are dissolved and destroyed, and the lymphatic vessel density is increased.