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目的:研究乳腺癌前哨淋巴结不同转移状态下前哨淋巴结与非前哨淋巴结成熟树突状细胞密度的改变。方法:回顾性分析79例符合研究标准的女性乳腺癌患者。根据前哨淋巴结的转移状况分为3组:A组(28例),所有淋巴结转移阴性;B组(25例),仅微小肿瘤出现于前哨淋巴结,包括B1组(16例),仅游离肿瘤细胞出现于前哨淋巴结;B2组(9例),仅微转移出现于前哨淋巴结;C组(26例),转移出现于前哨淋巴结,非前哨淋巴结有或无转移。所有前哨淋巴结及非前哨淋巴结蜡块切片均行与DC-LAMP抗体免疫反应的免疫组织学检查以确认成熟树突状细胞。蔡司图像分析系统定量分析每个淋巴结DC-LAMP阳性细胞的相对密度(DC-LAMP阳性细胞面积/淋巴结面积)。Wicoxon检验和Mann-Whitney检验分别用于DC-LAMP阳性细胞的相对密度的组内和组间比较。结果:DC-LAMP阳性细胞密度的组内比较显示A组和B组前哨淋巴结DC-LAMP阳性细胞平均密度较非前哨淋巴结高(P<0·05,P<0·01);C组前哨淋巴结DC-LAMP阳性细胞平均密度与非前哨淋巴结比较无明显差异(P>0·05)。组间比较显示各组前哨淋巴结DC-LAMP阳性细胞平均密度无显著差异;而B组(尤其B2组)非前哨淋巴结DC-LAMP阳性细胞密度较A组和C组显著升高(P<0·05,P<0·01)。结论:前哨淋巴结和非前哨淋巴结DC-LAMP阳性细胞平均密度在淋巴结肿瘤转移形成过程发生改变,揭示前哨淋巴结在肿瘤与引流淋巴结间相互作用中起重要作用。
OBJECTIVE: To investigate the changes of dendritic cell density in sentinel and non-sentinel lymph nodes in different metastases of sentinel lymph nodes in breast cancer. Methods: Retrospective analysis of 79 women with breast cancer who met the study criteria. According to the metastasis status of sentinel lymph nodes, they were divided into 3 groups: group A (28 cases), all lymph node metastases were negative; group B (25 cases), only tiny tumors appeared in sentinel lymph nodes, including group B1 (16 cases), only free tumor cells It occurred in the sentinel lymph node; in group B2 (nine cases), only micrometastasis occurred in the sentinel lymph node; group C (in 26 cases), metastasis occurred in the sentinel lymph node, and non-sentinel lymph node had or not metastasis. All sentinel and non-sentinel lymph node paraffin sections were immunohistochemically immunoreactive with DC-LAMP antibody to confirm mature dendritic cells. The ZEISS image analysis system quantifies the relative density of DC-LAMP positive cells in each lymph node (DC-LAMP positive cell area/lymph node area). The Wicoxon test and the Mann-Whitney test were used for intra- and inter-group comparisons of the relative densities of DC-LAMP positive cells, respectively. Results: Intra-group comparison of DC-LAMP positive cell density showed that the average density of DC-LAMP positive cells in sentinel nodes was higher in group A and group B than non-SLNs (P<0.05, P<0.01); Sentinel lymph nodes in group C The average density of DC-LAMP positive cells was not significantly different from that of non-sentinel lymph nodes (P>0.05). The comparison between groups showed that there was no significant difference in the average density of DC-LAMP positive cells in the sentinel nodes of each group, while the density of DC-LAMP positive cells in the non-sentinel nodes of group B (especially group B2) was significantly higher than that in groups A and C (P<0· 05, P<0·01). CONCLUSIONS: The average density of DC-LAMP positive cells in sentinel lymph nodes and non-sentinel lymph nodes changes during lymph node tumor metastasis, revealing that sentinel lymph nodes play an important role in the interaction between tumors and draining lymph nodes.