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目的:探讨“瘤芽”(tumor budding)在舌鳞癌中的病理学特征及其与上皮-间质转化(EMT)的关系。方法:HE染色评估230例舌鳞癌组织标本中肿瘤侵袭前沿和“瘤芽”的分布情况;免疫组织化学染色检测E-cadherin和Vimentin在舌癌中的表达及分布;应用SPSS13.0软件包进行Sperman相关分析,探讨“瘤芽”与临床、病理参数之间的关系,Kaplan-Meier法和Logrank分析生存率。结果:在舌鳞癌组织切片中,可见“瘤芽”位于肿瘤侵袭前缘,为单个或小于5个成簇的癌细胞。在230例病例中,111例标本呈现出高“瘤芽”状态(≥5个“瘤芽”/HPF),119例标本表现出低“瘤芽”状态(<5个“瘤芽”/HPF);“瘤芽”与肿瘤大小(P<0.05)、分化程度(P<0.05)、临床分期(P<0.05)以及淋巴结转移(P<0.001)呈正相关;与患者预后呈负相关,可作为舌鳞癌患者的独立预后判断指标(P=0.0014);构成“瘤芽”的癌细胞形态可由多边形、鱼鳞状转变成长梭形、成纤维细胞样;“瘤芽”与E-cadherin的表达呈负相关(P<0.01),与Vimentin的表达呈正相关(P<0.01),提示“瘤芽”与EMT相关,是EMT在组织形态学上的一种表现。结论:“瘤芽”与EMT密切相关,代表恶性程度更高的癌细胞亚群,可作为舌鳞癌患者独立的预后判断指标。
Objective: To investigate the pathological features of “tumor budding” in tongue squamous cell carcinoma and its relationship with epithelial-mesenchymal transition (EMT). Methods: The distribution of tumor invasion front and “tumor buds” in 230 specimens of tongue squamous cell carcinoma were evaluated by HE staining. The expression and distribution of E-cadherin and Vimentin in tongue carcinoma were detected by immunohistochemical staining. Software package Sperman correlation analysis to explore the “tumor bud” and the relationship between clinical and pathological parameters, Kaplan-Meier method and Logrank analysis of survival. Results: In tongue squamous cell carcinoma tissue sections, we can see that “tumor bud” is located in the front of tumor invasion and is a single or less than 5 clusters of cancer cells. Of the 230 cases, 111 had high “tumor buds” (≥5 “tumor buds” / HPF) and 119 had low “tumor buds” (<5 Tumor size (P <0.05), degree of differentiation (P <0.05), clinical stage (P <0.05), and lymph node metastasis (P <0.001) ; It was negatively correlated with the prognosis of patients and could be used as an independent prognostic indicator for tongue squamous cell carcinoma (P = 0.0014). The morphology of cancer cells forming “tumor bud” could be changed from polygons and fish scales to fusiform, fibroblastoid (P <0.01), which was positively correlated with the expression of Vimentin (P <0.01), suggesting that “tumor bud” is related to EMT, which is the result of EMT in tissue morphology A manifestation of learning. CONCLUSION: Lymphoma is closely related to EMT and represents a more malignant subpopulation of cancer cells, which can be used as an independent prognostic indicator in patients with tongue squamous cell carcinoma.