CAJ | 학술논문

目的探讨食管腺癌与鳞癌、正常食管组织淋巴管密度的差异及临床意义.方法收集2004年1月至2011年1月川北医学院附属医院行根治性手术切除的20例食管腺癌组织标本、同期手术切除的24例鳞癌组织标本及20例食管腺癌癌旁组织作为正常食管组织标本,采用免疫组织化学D2-40单染法检测食管腺癌组织中的淋巴管,D2-40/Ki-67双染法明确是否存在增殖的淋巴管,分析食管腺癌与食管鳞癌、正常食管组织淋巴管密度的差异.计量资料采用(x)±s表示,多组比较采用方差分析,两组比较采用t检验.结果 D2-40单染能区分淋巴管,D2-40/Ki-67双染可见增殖的淋巴管.食管腺癌、鳞癌及正常食管组织的淋巴管密度分别为:(3.3±1.7)个/0.17 mm2、(4.6±1.2)个/0.17 mm2、(3.8±1.2)个/0.17 mm2,3组比较,差异有统计学意义(F =5.44,P＜0.05)；食管腺癌淋巴管密度低于食管鳞癌,两组比较,差异有统计学意义(t=3.074,P＜0.05)；食管腺癌淋巴管密度低于正常食管组织淋巴管密度,两组比较,差异无统计学意义(t＝-1.022,P＞0.05)；食管鳞癌淋巴管密度大于正常食管组织淋巴管,两组比较,差异有统计学意义(t =2.395,P＜0.05).吞咽不适与疼痛为主诉的患者食管腺癌淋巴管密度比较,差异有统计学意义(t=3.092,P＜0.05)；病程＜6个月与≥6个月的患者食管腺癌淋巴管密度比较,差异有统计学意义(t=3.092,P＜0.05)；而食管腺癌淋巴管密度在不同性别、年龄、肿瘤部位、肿瘤直径、病理形态、T分期、N分期、G分期、TNM分期及有无淋巴结转移方面,差异无统计学意义(t=1.130,1.020,F=0.082,t=0.799,F=0.692,=0.694,1.820,0.353,0.969,0.969,P＞0.05).结论食管腺癌淋巴管密度低于食管鳞癌,但与正常食管组织淋巴管密度无明显差异.食管腺癌淋巴管密度与患者的症状及病程有关.
목적 탐토식관선암여린암、정상식관조직림파관밀도적차이급림상의의.방법 수집2004년1월지2011년1월천북의학원부속의원행근치성수술절제적20례식관선암조직표본、동기수술절제적24례린암조직표본급20례식관선암암방조직작위정상식관조직표본,채용면역조직화학D2-40단염법검측식관선암조직중적림파관,D2-40/Ki-67쌍염법명학시부존재증식적림파관,분석식관선암여식관린암、정상식관조직림파관밀도적차이.계량자료채용(x)±s표시,다조비교채용방차분석,량조비교채용t검험.결과 D2-40단염능구분림파관,D2-40/Ki-67쌍염가견증식적림파관.식관선암、린암급정상식관조직적림파관밀도분별위:(3.3±1.7)개/0.17 mm2、(4.6±1.2)개/0.17 mm2、(3.8±1.2)개/0.17 mm2,3조비교,차이유통계학의의(F =5.44,P＜0.05)；식관선암림파관밀도저우식관린암,량조비교,차이유통계학의의(t=3.074,P＜0.05)；식관선암림파관밀도저우정상식관조직림파관밀도,량조비교,차이무통계학의의(t＝-1.022,P＞0.05)；식관린암림파관밀도대우정상식관조직림파관,량조비교,차이유통계학의의(t =2.395,P＜0.05).탄인불괄여동통위주소적환자식관선암림파관밀도비교,차이유통계학의의(t=3.092,P＜0.05)；병정＜6개월여≥6개월적환자식관선암림파관밀도비교,차이유통계학의의(t=3.092,P＜0.05)；이식관선암림파관밀도재불동성별、년령、종류부위、종류직경、병리형태、T분기、N분기、G분기、TNM분기급유무림파결전이방면,차이무통계학의의(t=1.130,1.020,F=0.082,t=0.799,F=0.692,=0.694,1.820,0.353,0.969,0.969,P＞0.05).결론 식관선암림파관밀도저우식관린암,단여정상식관조직림파관밀도무명현차이.식관선암림파관밀도여환자적증상급병정유관.
Objective To investigate the differences on lymphatic vessel density (LVD) among esophageal adenocarcinoma (EAC),esophageal squamous cell carcinoma (ESCC) and normal esophageal tissues,and analyze the clinical significance.Methods Twenty samples of EAC,24 samples of ESCC and 20 cases of normal esophageal tissues were obtained at the Affiliated Hospital of North Sichuan Medical College from January 2004 to January 2011.D2-40 was used for immunostaining of lymphatic vessels in EAC,and antibodies of D2-40 and Ki-67 were used together to detect proliferation of lymphatic vessels.The differences in the LVD among EAC,ESCC and normal esophageal tissues were analyzed.All data were analyzed using the analysis of variance or t test.Results D2-40 staining could identify the lymphatic vessels,and antibodies of D2-40 and Ki-67 could detect the proliferation of lymphatic vessels.The LVD of EAC,ESCC and normal esophageal tissues were (3.3 ± 1.7)/0.17 mm2,(4.6 ± 1.2)/0.17 mm2 and (3.8 ± 1.2)/0.17 mm2,respectively,with significant differences (F =5.44,P ＜0.05).The LVD of EAC was significantly lower than that of ESCC (t =3.074,P ＜ 0.05),while there was no significant difference in the LVD between the EAC and normal esophageal tissues (t =-1.022,P ＞ 0.05).There were significant differences in the LVD between the ESCC and normal esophageal tissues (t =2.395,P ＜ 0.05).There were significant differences in the LVD between EAC patients with deglutition discomfort and those with pain (t =3.092,P ＜ 0.05).There were significant differences in the LVD between EAC patients with course ＜6 months and those with course≥6 months (t =3.092,P ＜ 0.05).No statistical difference in clinicopathological parameters including gender,age,site of lesion,tumor diameter,pathological morphology,T stage,N stage,G stage,TNM clinical stage and lymph node metastasis were detected (t ＝ 1.130,1.020,F =0.082,t =0.799,F =0.692,t =0.694,1.820,0.353,0.969,0.969,P ＞ 0.05).Conclusions The LVD of EAC is lower than that of ESCC,but is similar to that of normal esophageal tissues.The LVD of EAC is correlated with the symptoms and course of patients.