Audet Nathalie, Beasley Nigel J, MacMillan Christina, Jackson David G, Gullane Patrick J, Kamel-Reid Suzanne
Department of Otolaryngology, Wharton Head and Neck Centre, Princess Margaret Hospital, University of Toronto, Ontario, Canada.
Arch Otolaryngol Head Neck Surg. 2005 Dec;131(12):1065-70. doi: 10.1001/archotol.131.12.1065.
To examine the relationship between intratumoral lymphatic vessel density and clinical and pathological variables in patients with head and neck squamous cell carcinoma.
Archived paraffin-embedded biopsy specimens were sectioned and stained with hematoxylin-eosin and anti-LYVE-1 antibody, a highly specific marker for lymphatic endothelium. Tumor grade, infiltrating margin, inflammatory infiltrate, and percentage of tumor necrosis were noted and lymphatic vessel density measured using Chalkley point counting.
Tertiary care center at a university hospital.
A total of 168 previously untreated patients with advanced squamous cell carcinoma (73, larynx; 62, oropharynx; and 33, hypopharynx) treated with primary radiation (with or without planned neck dissection) and salvage surgery from 1992 to 1999.
Measurement of intratumoral lymphatic vessel density in pretreatment tissue biopsy specimen.
Disease-free and disease-specific survival, tumor occurrence, and nodal status.
In patients with laryngeal carcinoma there was a significant relationship between the presence of intratumoral lymphatics and nodal metastases at presentation (P = .02) and poorly differentiated tumor grade (P = .02). Patients with high lymphatic vessel density also had a significantly worse disease-specific survival (P = .03). However, this difference was not significant with multivariate analysis. No significant relationship existed between the presence of intratumoral lymphatics and any of the clinical or pathological variables in oropharyngeal and hypopharyngeal carcinoma.
In this patient sample, the development of intratumoral lymphatics in laryngeal carcinoma, but not in oropharyngeal or hypopharyngeal carcinoma, is associated with a spread of the tumor to regional lymph nodes. Detecting tumor lymphatic vessel proliferation is another step in the understanding of tumor biology, and the targeting of lymphatic growth may be of potential therapeutic benefit in selected patients with head and neck squamous cell carcinoma.
研究头颈部鳞状细胞癌患者瘤内淋巴管密度与临床及病理变量之间的关系。
对存档的石蜡包埋活检标本进行切片，并用苏木精-伊红和抗LYVE-1抗体染色，抗LYVE-1抗体是淋巴管内皮细胞的高度特异性标志物。记录肿瘤分级、浸润边缘、炎性浸润和肿瘤坏死百分比，并使用Chalkley点计数法测量淋巴管密度。
大学医院的三级医疗中心。
1992年至1999年期间，共有168例先前未经治疗的晚期鳞状细胞癌患者（73例喉癌；62例口咽癌；33例下咽癌）接受了原发放疗（有或无计划性颈部清扫）及挽救性手术。
测量治疗前组织活检标本中的瘤内淋巴管密度。
无病生存期和疾病特异性生存期、肿瘤发生情况及淋巴结状态。
在喉癌患者中，瘤内淋巴管的存在与就诊时的淋巴结转移（P = 0.02）及低分化肿瘤分级（P = 0.02）之间存在显著关系。淋巴管密度高的患者疾病特异性生存期也显著更差（P = 0.03）。然而，多因素分析显示这种差异不显著。在口咽癌和下咽癌中，瘤内淋巴管的存在与任何临床或病理变量之间均无显著关系。
在本患者样本中，喉癌而非口咽癌或下咽癌中瘤内淋巴管的形成与肿瘤向区域淋巴结的扩散有关。检测肿瘤淋巴管增殖是理解肿瘤生物学的又一步骤，针对淋巴管生长进行靶向治疗可能对部分头颈部鳞状细胞癌患者具有潜在的治疗益处。
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