泪腺腺样囊性癌嗜神经侵袭生长机制的免疫组化研究

发布时间：2018-09-12 06:18

【摘要】：研究目的运用免疫组织化学的技术分析泪腺腺样囊性癌(ACC)中三种雪旺氏细胞标记物S100、GFAP、Leu-7的表达并观察其与泪腺ACC组织嗜神经侵袭(PNI)等生物学行为之间的关系及与组织学类型的关系进一步为明确泪腺腺样囊性癌PNI机制提供实验依据,了解它们在泪腺ACC PNI微环境中的作用与关系,为临床寻找控制早期PNI的有效靶点提供参考依据。研究方法收集30例泪腺腺样囊性癌患者组织标本蜡块作为试验组,用已知阳性片(神经鞘膜瘤)作阳性对照、用0.01mmol/LPBS代替一抗作阴性对照；同时搜集该30例泪腺腺样囊性癌患者的个人信息；将30例泪腺腺样囊性癌患者的组织标本蜡块和5例正常泪腺组织蜡块进行切片及免疫组织化学染色；镜下检测试验组中S100蛋白、GFAP、Leu-7表达情况并与正常泪腺组织进行比较；按嗜神经性的有无分组,分别镜下分析各自的神经受侵率；按组织学类型分组(实体型、筛孔型、管状型,因后两者多混合存在,且本研究中样本量较小,故归为筛-管型,属高分化,而实体型属低分化)、按原发与复发分组,分别镜下分析泪腺腺样囊性癌组S100蛋白、GFAP、Leu-7表达的阳性率及神经受侵率；采用SPSS19.0统计学分析软件进行分析。对三种雪旺氏细胞标记物的表达结果进行分析,因n40,采用fisher确切概率法检验,以α=0.05为检验水准,当P0.05时,表明差异具有显著性。研究结果 1、30例泪腺腺样囊性癌患者组织标本蜡块切片经HE染色后,病理诊断结果与原取材的大组织诊断完全一致。 2、泪腺ACC组织中S100蛋白、GFAP均有不同程度表达,表达率依次为86.7%、83.3%,显著高于泪腺正常组织；两者染色均呈棕黄色为阳性,S100主要定位于胞浆和胞核中,GFAP主要在胞浆中表达；Leu-7在泪腺ACC与正常泪腺组织中均为阴性表达；低分化(实体型)ACC、复发组ACC的嗜神经侵袭率分别显著高于高分化型(筛-管型)、原发组ACC的嗜神经侵袭率,差异具有显著性(P0.05)。 3、低分化(实体型)ACC组织中的S100蛋白、GFAP表达率分别显著高于其在高分化型(筛-管型)ACC组织中的表达率；复发组ACC组织中表达率S100蛋白、GFAP分别显著高于其在原发组ACC组织中的表达率；有嗜神经侵袭组ACC中S100蛋白、GFAP的表达率分别显著高于其在无嗜神经侵袭组ACC中的表达率,上述差异具有显著性(P0.05)。结论 1、泪腺ACC具有嗜神经侵袭性生物学行为,嗜神经侵袭现象可作为泪腺ACC预后不良的临床观察指标之一。 2、泪腺ACC的分化程度越低(恶性程度越高),神经受侵率越高；复发性泪腺ACC与原发性泪腺ACC相比较,复发性泪腺ACC更容易侵袭神经,临床上可能引起不同程度的诸如疼痛及麻木等神经症状。 3、S100蛋白、GFAP分别在嗜神经组、复发组、低分化组中表达阳性率较高,可推测S100蛋白、GFAP在泪腺ACC嗜神经侵袭中发挥着一定作用,两者可以作为判断有无嗜神经侵袭现象的生物学指标。 4、Leu-7在泪腺ACC与正常泪腺组织中均为阴性表达,提示其与泪腺ACC的病变性质及神经侵袭无明确相关性。 5、泪腺ACC嗜神经机制是否与雪旺氏细胞分化有关,仍需要大样本量及多种的标记物实验证实,不同雪旺氏细胞标记物的敏感性及特异性均存在不同程度差异,寻求关于泪腺ACC PNI的特异性指标将成为一重要目标。
[Abstract]:research objective
The expression of three Schwann cell markers S100, GFAP and Leu-7 in lacrimal adenoid cystic carcinoma (ACC) was analyzed by immunohistochemical technique. The relationship between the expression of S100, GFAP and Leu-7 and the biological behavior of lacrimal ACC, such as neurotropic invasion (PNI), and the histological type of ACC was also observed. To understand their role and relationship in ACC PNI microenvironment of lacrimal gland, and to provide reference for clinical search for effective targets for early PNI control.
research method
Thirty cases of adenoid cystic carcinoma of lacrimal gland were collected as the experimental group, the known positive film (neurilemmoma) was used as the positive control, and 0.01 mmol/LPBS was used as the negative control.
30 cases of lacrimal adenoid cystic carcinoma and 5 cases of normal lacrimal gland tissue were sliced and immunohistochemically stained. The expression of S100 protein, GFAP, Leu-7 in the experimental group was detected under microscope and compared with that in the normal lacrimal gland tissue. Histologically grouped (solid type, ethmoidal type, tubular type, because the latter two are mixed, and the sample size in this study is small, it is classified as ethmoidal-tubular type, highly differentiated, but the solid type is poorly differentiated), according to the primary and recurrent grouping, the positive rates of S100 protein, GFAP, Leu-7 expression and nerve invasion in adenoid cystic carcinoma of lacrimal gland were analyzed under microscope. Rate;
SPSS19.0 statistical analysis software was used to analyze the expression results of three kinds of Schwann cell markers. Because of n40, Fisher exact probability method was used to test the expression of three kinds of Schwann cell markers. The test level was alpha=0.05. When P 0.05, the difference was significant.
Research results
After HE staining, the pathological diagnosis of 1,30 cases of adenoid cystic carcinoma of lacrimal gland was identical with that of the original large tissue.
2. The expression rates of S100 protein and GFAP in ACC tissues were 86.7% and 83.3% respectively, which were significantly higher than those in normal lacrimal gland tissues. The neurotropic invasion rate of metastatic (solid) ACC and recurrent ACC was significantly higher than that of well-differentiated (ethmoidal-tubular) ACC, and that of primary ACC was significantly higher (P 0.05).
3. The expression rates of S100 protein and GFAP in poorly differentiated (solid) ACC tissues were significantly higher than those in well differentiated (sieve-tube) ACC tissues; the expression rates of S100 protein and GFAP in recurrent ACC tissues were significantly higher than those in primary ACC tissues; the expression rates of S100 protein and GFAP in neurotropic invasive ACC tissues were significantly higher than those in primary ACC tissues. No significant difference was found in the expression rate of ACC in the non invasive group, and the difference was significant (P0.05).
conclusion
1. ACC of lacrimal gland has neurotropic invasive biological behavior, and neurotropic invasion can be used as one of the clinical indicators of poor prognosis of ACC of lacrimal gland.
2. The lower the degree of differentiation (the higher the degree of malignancy) of ACC in lacrimal gland, the higher the rate of nerve invasion; the recurrent lacrimal gland ACC is more likely to invade nerves than the primary lacrimal gland ACC, and may cause different degrees of clinical symptoms such as pain and numbness.
3. S100 protein and GFAP were expressed in the neurotropic group, recurrent group and poorly differentiated group respectively. It can be inferred that S100 protein and GFAP play a certain role in ACC neurotropic invasion of lacrimal gland. Both of them can be used as biological indicators to judge whether there is neurotropic invasion.
4. Leu-7 was negative in both lacrimal ACC and normal lacrimal gland tissues, suggesting that there was no definite correlation between Leu-7 and the pathological nature and nerve invasion of lacrimal ACC.
5. Whether the neural mechanism of ACC in lacrimal gland is related to the differentiation of Schwann cells still needs a large sample size and a variety of marker experiments to confirm that the sensitivity and specificity of different Schwann cell markers are different in varying degrees. It will be an important goal to seek specific indicators of ACC PNI in lacrimal gland.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.7

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