论文部分内容阅读
目的:观察微血管和淋巴管密度在鼻咽癌中的分布特点,探讨其对鼻咽癌复发转移和预后的意义。方法:对106例鼻咽癌患者的组织标本,采用微血管和淋巴管特异性标记物CD34和D2-40同期进行免疫组化检测,通过计算机辅助图像分析系统定量分析肿瘤周边及中心区域微血管和淋巴管分布状况,跟踪随访36～45个月,分析其与鼻咽癌复发转移和预后的关系。结果:106例鼻咽癌患者组织标本中,微血管和淋巴管染色均呈阳性表达,瘤周微血管和淋巴管密度均大于瘤内。单因素分析显示瘤内微血管密度、瘤内和瘤周淋巴管密度与鼻咽癌复发转移相关(P<0.05),而年龄、性别、T分期、N分期、临床分期,以及瘤周微血管密度与之不相关(P>0.05);多因素分析显示瘤内微血管密度和瘤周淋巴管密度是鼻咽癌复发转移的独立风险因素。瘤内微血管密度高表达与鼻咽癌的不良预后密切相关(P<0.05)。结论:微血管和淋巴管密度高表达是评估鼻咽癌预后不良的指标。瘤内和瘤周微血管、淋巴管在肿瘤复发转移中可能发挥着不同的作用,瘤内微血管和癌周淋巴管应成为鼻咽癌治疗的靶点。
OBJECTIVE: To observe the distribution of microvessel density and lymphatic vessel density in nasopharyngeal carcinoma (NPC), and to explore its significance for the recurrence, metastasis and prognosis of NPC. Methods: 106 cases of nasopharyngeal carcinoma tissue samples using microvascular and lymphatic specific markers CD34 and D2-40 simultaneous immunohistochemical detection by computer-assisted image analysis system quantitative analysis of tumor peripheral and central regions of the microvessels and lymph nodes Tube distribution, follow-up of 36 to 45 months, analysis of its relationship with recurrence, metastasis and prognosis of nasopharyngeal carcinoma. Results: Tissue samples of 106 patients with NPC showed positive staining of microvessels and lymphatic vessels, and the density of peritumoral microvessels and lymphatic vessels were all higher than that in the neoplasms. Univariate analysis showed that intratumoral microvessel density, intratumoral and peritumoral lymphatic vessel density correlated with the recurrence and metastasis of NPC (P <0.05), while age, sex, T stage, N stage, clinical stage, (P> 0.05). Multivariate analysis showed that intratumoral microvessel density and peritumoral lymphatic vessel density were independent risk factors for recurrence and metastasis of NPC. The high expression of intratumoral microvessel density is closely related to the poor prognosis of nasopharyngeal carcinoma (P <0.05). Conclusion: The high density of microvessel and lymphatic vessel is the index to evaluate the poor prognosis of nasopharyngeal carcinoma. The intratumoral and peritumoral capillaries and lymphatic vessels may play different roles in tumor recurrence and metastasis, and the intratumoral microvessels and perivascular lymphatic vessels should be the targets of nasopharyngeal carcinoma treatment.