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口腔鳞状细胞癌中颈部淋巴结的免疫形态学模式

Immunomorphological patterns of cervical lymph nodes in oral squamous cell carcinoma.

作者信息

Chandavarkar Vidyadevi, Uma K, Sangeetha R, Mishra Mithilesh

机构信息

Department of Oral Pathology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India.

Department of Oral Pathology, Karnataka Lingayat Education Society Institute of Dental Sciences, Bangalore, Karnataka, India.

出版信息

J Oral Maxillofac Pathol. 2014 Sep-Dec;18(3):349-55. doi: 10.4103/0973-029X.151311.

DOI:10.4103/0973-029X.151311
PMID:25948987
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4409177/
Abstract

CONTEXT

Squamous cell carcinoma (SCC) comprises 80% of the cancers of the oral cavity. Metastases to the cervical lymph nodes affects prognosis. Studying lymph node reactivity may help to understand host immune reaction against the tumor and thus influence prognosis.

AIMS

This study observed patterns of lymph node reactivity, metastases and grades of metastases in cervical lymph nodes and compared them with the histopathology of the primary tumor.

MATERIALS AND METHODS

Lymph nodes from 30 patients of oral squamous cell carcinoma (OSCC) were taken. 10 of these were well-differentiated SCC (WDSCC), 10 moderately differentiated SCC (MDSCC) and 10 poorly differentiated SCC (PDSCC). Four immunomorphological patterns were observed: lymphocyte predominance, germinal centre predominance, mixed pattern (sinus histiocytosis) and unstimulated pattern.

STATISTICAL ANALYSIS USED

Chi square test.

RESULTS

The predominant lymph node reactive patterns were germinal centre predominance (79.27%), unstimulated pattern (14.63%) and lymphocyte predominance (6.10%). Positive nodes showed invasion in the form of islands (57.14%), cords (39.29%) and total replacement pattern (3.57%). Tumor involvement in positive nodes showed grade 3 invasion, (53.57%), grade 2 invasion (26.79%), grade 4 invasion (17.86%) and grade 1 invasion (1.79%). Statistically significant association was found between: Lymph node reactive pattern and histopathological grade of primary tumor. Higher numbers of germinal centre predominance lymph nodes were found in WDSCC and MDSCCHistopathological grade of primary tumor and the grade of lymph node invasion.

CONCLUSIONS

Immuno-morphological assessment of draining lymph nodes reflects the immune status of the patient with respect to metastases. This may facilitate identification of high and low risk patients and help in planning appropriate therapy for the high-risk patients.

摘要

背景

鳞状细胞癌（SCC）占口腔癌的80%。颈部淋巴结转移会影响预后。研究淋巴结反应性可能有助于了解宿主对肿瘤的免疫反应，从而影响预后。

目的

本研究观察颈部淋巴结的反应模式、转移情况及转移分级，并将其与原发肿瘤的组织病理学进行比较。

材料与方法

选取30例口腔鳞状细胞癌（OSCC）患者的淋巴结。其中10例为高分化SCC（WDSCC），10例为中分化SCC（MDSCC），10例为低分化SCC（PDSCC）。观察到四种免疫形态学模式：淋巴细胞为主型、生发中心为主型、混合模式（窦组织细胞增生）和未刺激型。

统计分析方法

卡方检验。

结果

主要的淋巴结反应模式为生发中心为主型（79.27%）、未刺激型（14.63%）和淋巴细胞为主型（6.10%）。阳性淋巴结的侵袭形式为岛状（57.14%）、条索状（39.29%）和完全替代型（3.57%）。阳性淋巴结中的肿瘤累及显示3级侵袭（53.57%）、2级侵袭（26.79%）、4级侵袭（17.86%）和1级侵袭（1.79%）。在以下方面发现了具有统计学意义的关联：淋巴结反应模式与原发肿瘤的组织病理学分级。在WDSCC和MDSCC中发现生发中心为主型的淋巴结数量较多；原发肿瘤的组织病理学分级与淋巴结侵袭分级。

结论

引流淋巴结的免疫形态学评估反映了患者关于转移的免疫状态。这可能有助于识别高风险和低风险患者，并有助于为高风险患者制定适当的治疗方案。

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