口腔鳞癌不同区域病理分级及增殖活性的差异  

The Difference of WHO Pathological Grading and Cell Proliferating Activity between Different Parts of Oral Squamous Cell Carcinoma

作　　者：张强[1] 张永福[1] 卓夏阳[2] 贾芸香[2] 

机构地区：[1]江西医学院附属口腔医院口腔颌面外科,江西南昌330006 [2]江西医学院附属口腔医院口腔病理科,江西南昌330006

出　　处：《口腔医学研究》2004年第6期586-588,共3页Journal of Oral Science Research

摘　　要：目的 :研究口腔鳞癌不同区域的病理分级 (WHO)及细胞增殖活性的差异 ,并探讨其临床意义和理论意义。方法 :对 15例口腔鳞癌手术切除的标本按照统一标准分为表面区、中心区、深层浸润区、癌旁区和正常组织 5部分。分别对表面区、中心区、深层浸润区和同一患者的术前活检标本进行病理分级 (WHO) ,观察比较其差异。采用PCNA免疫组化染色方法来研究细胞的增殖活性 ,观察术后标本各区之间阳性表达差异。结果 :口腔鳞癌术后标本表面区、中心区、深层浸润区和术前活检组织之间病理分级存在明显差异 ,其中深层浸润区病理分级最差 ,表面区、中心区病理分级与术前活检组织相当。表面区→中心区→深层浸润区肿瘤细胞PCNA阳性表达逐渐增强 ,癌旁区比正常组织阳性表达要高。结论 :口腔鳞癌内部不同区域之间的病理分级及细胞增殖活性并不相同 ,只有深层浸润区最能反映肿瘤的生物学特征 ,最能代表肿瘤当前阶段的性质 ,术前活检组织不能准确反映肿瘤的恶性程度 ;癌旁组织与正常组织相比细胞增殖活性明显增强 ,已处于癌前状态。Objective: To study the difference of pathological grading(WHO) and cell proliferating activity between different parts of oral squamous cell carcinoma, to discuss its clinical and theoretical significance. Method: Each specimens of 15 OSCC cases was divided into 5 parts, including surface, center, deep invasive part, tissue adjacent to carcinoma and normal part. The surface, center, deep invasive part and corresponding preoperative biopsy tissue were graded(WHO) respectively. PCNA immunohistochemical method was used to study the cell proliferating activity and the differences between surface, center, deep invasive part, tissue adjacent to carcinoma and normal part. Results: There were pathological grading differences between different parts of OSCC (P<0.05). The deep invasive part were more poorly differentiated than any other parts. The grade of preoperative biopsy tissue was similar to that of surface and center. From surface to the deep invasive part ,the expression of PCNA became more and more intensive, especially in the deep invasive part. The positive cells were also more in tissue adjacent to carcinoma than normal. Conclusions: There were differences on pathological grading and cell proliferating activity between different partsin OSCC, only the deep invasive part can reflect the biologic character of OSCC.

关 键 词：口腔鳞状细胞癌 病理分级(WHO) 增殖细胞核抗原 癌旁组织 

分 类 号：R739.81[医药卫生—肿瘤]