食管鳞癌患者郎格罕细胞与预后的分析  

TherelationshipbetweenprognosisofesophagealsquamouscarcinomaandLangerhanscell

作　　者：侯维平[1,2] 刘锟[1,2] 曲家骐[1,2] 金玲 马富锦[1,2] 李玉霞 王建清[1,2] 

机构地区：[1]解放军沈阳军区总医院 [2]西安第四军医大学唐都医院胸外科

出　　处：《中华外科杂志》1996年第7期430-432,共3页Chinese Journal of Surgery

摘　　要：为了了解食管癌患者肿瘤中郎格罕细胞（ＬＣ）的分布与预后的关系，作者对１６７例连续手术切除的食管鳞癌组织标本，用免疫组化（ＡＢＣ）方法Ｓ－１００蛋白染色，观察了ＬＣ在肿瘤癌巢内、癌巢周、间质内、癌旁粘膜及淋巴滤泡五个不同部位中的形态、数量及分布特点，以及与病理分期的关系；对随访３年以上的１２７例，观察了癌组织不同部位中ＬＣ的数量与存活时限的关系。结果发现ＬＣ在癌巢内及淋巴滤泡中的数量，随食管癌的ＴＮＭ分期增大而明显增多，Ⅲ、Ⅳ期病变癌巢内的ＬＣ均值比Ⅱ期者显著增值，呈正相关。由此提示，癌巢内ＬＣ增多的患者生存期较短；而癌巢周、癌旁粘膜及间质内ＬＣ增多的患者生存期较长。这两点可作为判定患者预后的免疫学方面的新指标。Theoperativetumorspecimenofesophagealsquamouscarcinomawerestudiedwithim-munohistochemical(ABC)methodS-100proteinstaining.Underthelightmicroscopy,weobservedthemorphology,numberanddistributionofLangerhan'scels(LC)indiferentportionofthetumormassanditsrelationshipwiththepathologicalstagingin167cases.Weobservedalsotherelationshipbe-tweenLCandthepostoperativesurvivalperiodin127casesfolowedformorethan3years.Thesere-sultssuggestedfoundthatpositiverelationbetweenthenumberofLCinthecancernestandinthelym-phfoliclewiththeincreasingofTNMclassification.ThenumberofLCinthecancernestsignificantlyincreasedinstageⅢandⅣcasesthanstageⅡcases.Onthecontrary,thenumberofLCintheperi-tumorandinterstitialtissuedecreasedwhiletheTNMclassificationwasincreasing.Thesefindingssug-gestedthatthesurvivalperiodwasshorterinpatientswhoseLChadincreasedinthecancernest,whereasthesurvivalperiodwouldbelongerinthosepatientswhoseLChadincreasedinthetissuearoundthetumormass,inthemucosanearthetumoraswelasintheinterstitialtissue.Thesetwopointsmightbeusedasanimmunologicalpara-meterfortheassessmentoftheprognosis.

关 键 词：食管肿瘤 郎格罕细胞 鳞癌 

分 类 号：R735.1[医药卫生—肿瘤]