口腔扁平苔藓、白斑及鳞癌棘细胞形态计量学分析  

Morphometric and stereologic analysis of spinous cells in oral lichen planus,leukoplakia and squamous cell carcinoma

作　　者：蔡扬[1] 于燕妮[2] 柳咏发[3] 卢虹[1] 杨宏[1] 

机构地区：[1]贵州贵阳医学院附院口腔科,550004 [2]贵州贵阳医学院附院病理科,550004 [3]武警贵州总队医院口腔科

出　　处：《实用口腔医学杂志》2006年第3期404-407,共4页Journal of Practical Stomatology

基　　金：贵州省卫生厅基金(B98-8);贵阳医学院博士启动基金(C2005-9)资助

摘　　要：目的:从形态计量学角度探讨口腔扁平苔藓(OLP)癌变的可能性,并为口腔黏膜良恶性病变的鉴别诊断提供客观参考资料。方法:采用多功能图象分析系统对取自口腔黏膜的正常、口腔扁平苔藓(OLP)、伴轻、中度上皮异常增生白斑(LK)、鳞癌(SCC)的上皮棘层细胞及胞核进行形态计量学研究分析,选择表示细胞及细胞核大小和形状的二维参数9个,体视学参数10个,并比较这些参数在各组间的变化趋势及差异。结果:无论从二维或三维的各项形态学指标,OLP的测量值都处于正常与LK和鳞癌之间,与正常组相比,各参数值多无显著性差异,而与鳞癌组差异显著。结论:OLP是一种介于正常与轻、中度上皮异常增生之间的病变,具有一定的癌变倾向,但癌变潜能低于癌前白斑。二维定量和三维定量结合可更全面地反映口腔黏膜癌变过程中细胞及细胞核的量变质变过程;核质比值、细胞核体积密度可作为鉴别良恶性病变的参考指标。Objective： To evaluate the malignant potential of oral lichen planus （OLP） by measuring and analyzing the dimensions of spinous cell in mucosal epithelium. Methods：Paraffin-embedded samples of oral mucosa, including normal （ N,7 cases）, OLP（ 16 cases）, oral leukoplakia（ 12 cases） with miht and moderate epithelial dysplasia （LK） and well differentiated oral squamous cell carcinoma （SCC,10 cases）, were analyzed by MIAS- 99 System. The planar and stereoscopic dimensions of spinous cells were measured and compared. Results：The values of morphometric and stereologic parameters in OLP were between those in normal mucosa and in LK, significantly different from those in SCC and not significantly different from those in normal epithelium. Conclusion：Based on the changes of cell morphometrie parameter value, OLP is generally a benign lesion with some degree of malignant potentiality that is less than LK. Nucleus/cytoplasm volume ratio and volume density of cell nucleus of spinous cells in mucosal epithelium are of value in distinguishing benign from maliganant lesions.

关 键 词：口腔扁平苔藓 白斑 鳞状细胞癌 体视学 形态定量学 

分 类 号：R781.5[医药卫生—口腔医学]