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目的 :探讨口腔疣状癌超微结构特征 ,对疣状癌提出分型。方法 :取正常口腔黏膜 ,口腔疣状癌 ,口腔高分化鳞癌及低分化鳞癌石蜡标本各 8例 ,常规电镜制样 ,H -60 0型透射电镜检测。结果 :口腔疣状癌超微结构可归纳为 3种类型 :Ⅰ型 :癌上皮细胞分化较好 ,形态规则 ,细胞间隙略窄 ,细胞间有丰富且形态规则的桥粒 ,胞浆内线粒体少 ,但粗面内质网丰富 ,胞浆内未见桥粒。上皮间可见角化珠。Ⅱ型癌上皮细胞分化很差 ,细胞异形性明显 ,细胞间桥粒散在 ,细胞内桥粒丰富 ,包裹成团 ,粗面内质网少。Ⅲ型 :癌上皮细胞瘦长 ,核浆浓缩 ,细胞间隙较高分化鳞癌宽 ,细胞间桥粒瘦长且丰富。结论 :口腔疣状癌超微结构变化是其临床生物学行为多样性的基础 ,由此推测疣状癌自身可能存在不同的亚型和分化潜能。
OBJECTIVE: To investigate the ultrastructural features of oral verrucous carcinoma and to put forward the classification of verrucous carcinoma. Methods: Normal oral mucosa, oral verrucous carcinoma, well-differentiated oral squamous cell carcinoma and poorly differentiated squamous cell carcinoma were collected in 8 cases. The samples were examined by conventional electron microscope and H-60 0 transmission electron microscope. Results: The ultrastructure of oral verrucous carcinoma could be classified into three types: type Ⅰ: the carcinoma epithelial cells were well differentiated, with regular morphology, slightly narrow interstitial space, abundant and regular desmosomes among cells, few mitochondria in cytoplasm , But rich in rough endoplasmic reticulum, cytoplasm no desmosomes. Keratosis between the epithelial beads can be seen. Type II cancer epithelial cells are poorly differentiated, cell shape is obvious, intercellular desmosome scattered, intracellular desmosomes rich, parcels into groups, less rough endoplasmic reticulum. Type III: cancer epithelial cells elongated, nuclear plasma concentration, high-grade cell division squamous cell carcinoma wide, desmoglein elongated and rich. CONCLUSIONS: The ultrastructural changes of oral verrucous carcinoma are the basis of its diversity in clinical biological behavior, suggesting that there may be different subtypes and differentiation potential in verrucous carcinoma.