早期结直肠癌间质中podoplanin表达模式及病理诊断意义  

Expression pattern of podoplanin in the stroma of early stage colorectal cancer and its clinical significance

作　　者：高杨 岳冰[1] 杜雪梅 陈烨 徐瑞[1] 贾梅 刘耘汐 张鑫[1] 陈光勇[1] GAO Yang;YUE Bing;DU Xuemei;CHEN Ye;XU Rui;JIA Mei;LIU Yunxi;ZHANG Xin;CHEN Guangyong(Department of Pathology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院病理科,北京100050

出　　处：《临床与实验病理学杂志》2024年第12期1256-1260,1267,共6页Chinese Journal of Clinical and Experimental Pathology

基　　金：国家重点研发计划(2023YFC2507400、2023YFC2507406)。

摘　　要：目的探讨podoplanin在早期结直肠癌间质癌性腺体周围成纤维细胞及癌症相关成纤维细胞(cancer-associated fibroblasts,CAFs)中的表达模式,分析其与临床病理特征的关系及病理诊断意义。方法入组早期结直肠癌病例166例,采用免疫组化EnVision两步法检测间质podoplanin免疫组化表达情况并进行分型。模式A为所有癌性腺体周围成纤维细胞均极向保留、均匀一致着色且强度大于腺体周围CAFs,且完全包绕腺体;模式B为癌性腺体周围成纤维细胞失去极向或出现表达丢失,且着色强度小于等于腺体周围CAFs;统计分析两种表达模式与临床病理特征的相关性。结果166例中模式A组55例,模式B组111例。单因素分析显示:两组在淋巴管侵犯、血管侵犯、出芽分级、分化程度、浸润形式及Kikuchi分级上差异有统计学意义(P<0.05);多因素分析显示:两组在浸润形式上差异有统计学意义(P<0.05)。结论早期结直肠癌间质存在不同的podoplanin表达模式且与结直肠癌淋巴结转移危险因素具有相关性,同时可作为辅助诊断工具,提高病理医师对浸润形式判断的一致性。Purpose To investigate the expression pattern of podoplanin in the periglandular fibroblasts and cancer-associated fibroblasts of early-stage colorectal cancer,to analyze its relationship with clinicopathological features,and to explore its significance in clinicopathological diagnosis.Methods A total of 166 cases of early-stage colorectal cancer were enrolled.The deepest invasion tissue samples from 166 cases were explored with immunohistochemistry for expression profiling of podoplanin.According to the expression pattern of analyze in the stroma,Pattern A showed that the periglandular fibroblasts were pole-oriented and uniformly expressed podoplanin,and stronger than CAFs around the glands,periglandular fibroblasts completely surround the glands;Pattern B showed that the periglandular fibroblasts were loss of cell polarity,and the staining intensity was less than or equal to CAFs around the glands.And the correlation was also analyzed between the two expression patterns and clinicopathological features.Results Among 166 cases,55 cases were the Pattern A of podoplanin expression and 111 cases were the Pattern B.Monofactor analysis showed statistically significant differences in lymphatic vessel invasion,vascular invasion,budding grade,differentiation degree,infiltration pattern and Kikuchi classification between the two groups(P<0.05).Multivariate analysis identified that infiltration pattern was an independent factor between the two groups(P<0.05).Conclusion Podoplanin expression patterns are different in the stroma of early colorectal cancer and correlated with risk factors for lymph nodes metastasis.In clinicopathological diagnosis,podoplanin can be used as an auxiliary diagnostic tool to improve the consistency of pathologists’judgment of infiltration forms.

关 键 词：结直肠癌 早期 PODOPLANIN 间质 癌症相关成纤维细胞 癌性腺体周围成纤维细胞 

分 类 号：R735.3[医药卫生—肿瘤]