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目的 探索脑肿瘤的血道转移发生机制。方法 应用透射电镜技术及免疫组化技术对脑肿瘤毛细血管超微结构水平及免疫组化水平的结构改变进行比较观察。结果 超微结构观察发现 ,胶质瘤中微血管基膜连续 ,完整 ,厚薄不均匀 ,有分层 (层内夹有周细胞 ) ,与正常脑组织血管基膜无异。转移瘤中基膜不清晰 ,不连续 ,纤细疏松 ,有典型窗孔结构。免疫组化结果显示Col lagenⅣ ,Fibronectin ,Laminin(CollⅣ ,FN ,LM ) 3种抗原在正常脑组织及脑瘤组织中的血管基膜和软脑膜均有表达 ,各型、各级胶质瘤血管基膜部分呈线状连续完整 ,部分呈分层网格状增厚。 3种基膜成分在转移瘤内及周边血管中均有不同程度表达 ,且基膜呈线状连续完整。结论 胶质瘤细胞虽有一定程度的异形性 ,但胶质瘤中的血脑屏障从形态学上未见异常 ,说明胶质瘤细胞具有诱导血脑屏障形成的特性。这可能是不发生颅外转移的原因之一。脑转移瘤的血管形态不具备有完整的血脑屏障的结构特征。
Objective To explore the mechanism of hematogenous metastasis in brain tumor. Methods Transmission electron microscopy and immunohistochemistry were used to observe the ultrastructural changes of the capillary vessels and the immunohistochemical changes in brain tumors. Results Ultrastructural observation showed that the microvascular basement membrane in glioma was continuous, intact, uneven in thickness, with stratification (with pericytes in the layer), which was similar to that in normal brain tissue. Metastatic tumor base film is not clear, not continuous, slender loose, a typical window structure. The results of immunohistochemistry showed that the expression of Col lagenⅣ, Fibronectin, Laminin (Coll Ⅳ, FN, LM) were both in the basal and pia mater of normal brain tissue and brain tumor, and all types and grades of glioma The basement membrane part of the linear continuous integrity, some stratified gridded thickening. Three basement membrane components in the metastases and peripheral blood vessels were expressed to varying degrees, and the basement membrane linear continuous integrity. Conclusion Although there is a certain degree of atypia in glioma cells, the blood-brain barrier in gliomas shows no morphological abnormalities, indicating that glioma cells have the property of inducing blood-brain barrier formation. This may be one of the causes of no extracranial metastases. Blood vessel morphology of brain metastases do not have the structural features of a complete blood-brain barrier.