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目的 研究口腔粘膜疣状癌基膜Ⅳ型胶原与层粘连蛋白的表达、分布和超微结构改变。方法 采用免疫组化S P法 ,分别检测 16例疣状癌、10例鳞癌和 9例中至重度不典型增生病例中Ⅳ型胶原与层粘连蛋白的表达 ,对表达结果作定量分析 ,并对 3例疣状癌作电镜观察。结果 疣状癌基膜大多数较厚且保持完整 (13/ 16 ) ,电镜下观察基板在一些区域明显增厚。但炎症细胞较多的病例 ,基膜出现中断 (3/ 16 )。鳞癌和中至重度不典型增生基膜相对较薄 ,鳞癌基膜绝大多数不连续 (9/ 10 ) ,尤其在浸润的前沿或小条索状癌结构中 ,基膜基本中断或消失。中至重度不典型增生基膜大多数连续 (6 / 9)。所有病例的癌巢周围间质中都可见炎症细胞浸润 ,疣状癌较鳞癌和中至重度不典型增生中浸润的淋巴细胞更为密集 (P <0 0 5 )。在疣状癌中 ,上皮内炎症细胞浸润与其基膜完整呈正相关关系 (P <0 0 1)。结论 疣状癌基膜较厚 ,较完整且结缔组织中有大量以淋巴细胞为主的炎症细胞浸润 ,可能与其生物学行为有关
Objective To study the expression, distribution and ultrastructural changes of type IV collagen and laminin in the oral mucosal verrucous carcinoma basement membrane. Methods Immunohistochemical SP method was used to detect the expression of type IV collagen and laminin in 16 cases of verrucous carcinoma, 10 cases of squamous cell carcinoma and 9 cases of moderate to severe dysplasia. The expression results were analyzed quantitatively. Three cases of verrucous carcinoma were observed under electron microscope. Results Most of the base films of the verrucous carcinoma were thick and remained intact (13/16). Under the electron microscope, the substrate was thickened obviously in some areas. However, in cases with more inflammatory cells, the basement membrane was disrupted (3/16). The basal membranes of squamous cell carcinoma and moderate-to-severe atypical hyperplasia are relatively thin, and the vast majority of squamous cell carcinoma basement membranes are discontinuous (9/10). Especially in the infiltrating frontal or small cord-like carcinoma structures, the basement membrane is basically interrupted or disappears. . The majority of moderate to severe atypical hyperplasia basements are continuous (6/9). Inflammation infiltration was observed in the interstitial space around the cancer nest in all cases. Vertebral carcinoma was denser than lymphocytes infiltrated by squamous cell carcinoma and moderate to severe dysplasia (P < 0.05). In the verrucous carcinoma, the infiltration of inflammatory cells in the epithelium was positively correlated with the integrity of the basement membrane (P < 0.01). Conclusions The basement membrane of verrucous carcinoma is thicker, more complete, and there is a large number of lymphocyte-based inflammatory cell infiltration in connective tissue, probably related to its biological behavior.