论文部分内容阅读
目的探讨新生淋巴管及肿瘤内环境因子在宫颈癌淋巴结转移中的作用机理。方法采用免疫组化方法检测宫颈癌(60例)、宫颈上皮内瘤变(CIN 3,20例)及正常宫颈(20例)组织中D2-40的表达和宫颈癌组织中CXCR4和CCR7的表达,及在宫颈癌深肌层和浅肌层中的表达。检测宫颈癌盆腔淋巴结中基质细胞衍生因子1(SDF-1)及CCL21的表达。显微镜下观察D2-40阳性表达的癌边缘淋巴管结构及组织中正常淋巴管结构。结果宫颈癌组织中的D2-40表达量高于CIN3组织和正常宫颈组织(26.72±1.75vs.13.95±1.48和2.08±0.65)(P<0.01)。CXCR4和CCR7在宫颈癌组织呈高表达,但在正常宫颈组织中为阴性,CIN 3组织部分为弱阳性表达;SDF-1和CCL21在宫颈癌患者盆腔5组淋巴结表达阳性。新生淋巴管密度与宫颈癌直径有关,深肌层侵犯者的新生淋巴管密度较浅肌层侵犯者增加(P<0.01)。结论宫颈癌组织可诱导产生新生淋巴管。淋巴管内皮细胞产生淋巴管趋化因子受体。新生淋巴管与组织淋巴管交汇,是宫颈癌淋巴结转移的重要桥梁。SDF-1和CCL21的淋巴结高表达是募集肿瘤细胞重要的趋化因子。新生淋巴管与肿瘤细胞交互作用,使肿瘤细胞向淋巴管迁徙,发生淋巴结转移。
Objective To investigate the mechanism of lymphangiogenesis and environmental factors in cervical lymph node metastasis. Methods The expression of D2-40 and the expression of CXCR4 and CCR7 in cervical cancer (60 cases), cervical intraepithelial neoplasia (CIN 3,20 cases) and normal cervix (20 cases) were detected by immunohistochemistry , And in cervical myometrial and superficial myometrial expression. The expression of stromal cell-derived factor 1 (SDF-1) and CCL21 in pelvic lymph nodes of cervical cancer was detected. Under the microscope, we observed the structure of lymphangioma of D2-40 positive and the normal lymphatic vessel structure in the tissue. Results The expression of D2-40 in cervical cancer tissues was higher than that in CIN3 tissues and normal cervical tissues (26.72 ± 1.75vs.13.95 ± 1.48 and 2.08 ± 0.65) (P <0.01). CXCR4 and CCR7 were highly expressed in cervical cancer tissues, but negative in normal cervical tissues, but weakly positive in CIN 3 tissues. SDF-1 and CCL21 were positive in 5 groups of lymph nodes in cervical cancer patients. The density of newly diagnosed lymphatic vessels is related to the diameter of cervical cancer, and the density of newly diagnosed lymphatic vessels in the deep muscular invasion is higher than that of the normal muscular invasion (P <0.01). Conclusion Cervical cancer tissue can produce newborn lymphatic vessels. Lymphatic vessel endothelial cells produce lymphatic chemokine receptors. Lymphangiogenesis and tissue lymphatic confluence, cervical lymph node metastasis is an important bridge. High expression of lymph nodes in SDF-1 and CCL21 is an important chemokine for recruiting tumor cells. Neonatal lymphatic vessels and tumor cells interact, so that the migration of tumor cells to the lymphatic vessels, the occurrence of lymph node metastasis.