發(fā)布時間：2018-05-09 02:34

  本文選題：D2-40 + 淋巴通路��； 參考：《首都醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探索D2-40在正常淋巴結(jié)及病變淋巴結(jié)的表達(dá)特征并總結(jié)其規(guī)律。方法收集北京友誼醫(yī)院病理科正常淋巴結(jié)54枚、病變淋巴結(jié)36枚,觀察HE切片組織形態(tài),應(yīng)用免疫組織化學(xué)Eli Vision法對淋巴結(jié)行D2-40染色,觀察D2-40免疫表型特征。結(jié)果1.D2-40在正常淋巴結(jié)被膜下竇呈陽性(49/54),淋巴竇呈陰性或弱陽性(49/54)。但有4枚淋巴結(jié)淋巴竇明顯擴(kuò)張,竇內(nèi)皮細(xì)胞增生,淋巴竇周圍可見大量的漿細(xì)胞聚集,此時淋巴竇D2-40染色強(qiáng)陽性。2.D2-40在正常淋巴結(jié)(16/54)的濾泡間區(qū)、副皮質(zhì)區(qū)可見多量D2-40染色陽性的管狀結(jié)構(gòu),這些小管即為文獻(xiàn)報道的淋巴迷路。3.增生活躍的淋巴結(jié)(14/54)較增生不活躍淋巴結(jié)(40/54)內(nèi)淋巴迷路數(shù)量多,染色強(qiáng),差異存在統(tǒng)計學(xué)意義(P0.05)。4.癌轉(zhuǎn)移淋巴結(jié)15枚,9/15枚淋巴結(jié)殘存的被膜下竇D2-40染色呈陽性,淋巴竇均陰性。3枚淋巴結(jié)(胃印戒細(xì)胞癌2枚,未確定類型癌1枚),癌組織被淋巴迷路包圍,并不破壞淋巴結(jié)的結(jié)構(gòu)。5.淋巴瘤淋巴結(jié)21枚,16/18枚淋巴結(jié)被膜下竇D2-40染色呈陽性,淋巴竇陰性。18/21枚淋巴結(jié)內(nèi)可見淋巴迷路,但數(shù)量及染色強(qiáng)度未見明顯規(guī)律。結(jié)論1.D2-40不僅在淋巴管內(nèi)皮細(xì)胞表達(dá),也可在淋巴竇內(nèi)皮細(xì)胞表達(dá),特別是被膜下竇。2.淋巴結(jié)的副皮質(zhì)區(qū)存在多量D2-40染色陽性的小管狀結(jié)構(gòu),即淋巴迷路。本研究首次通過D2-40染色印證了人體淋巴結(jié)內(nèi)存在淋巴迷路。3.增殖狀態(tài)的淋巴結(jié)內(nèi)淋巴迷路的數(shù)量更多,D2-40染色更強(qiáng)。4.D2-40免疫組化染色顯示淋巴迷路比傳統(tǒng)的掃描電鏡方法更實用、簡單有效,為研究淋巴結(jié)內(nèi)淋巴網(wǎng)路提供了新的手段。5.通過D2-40研究淋巴竇和淋巴迷路,有助于更清晰地認(rèn)識淋巴結(jié)的基本結(jié)構(gòu)、更好地理解淋巴結(jié)內(nèi)疾病形成的規(guī)律。
[Abstract]:Objective to investigate the expression of D 2-40 in normal and diseased lymph nodes. Methods 54 normal lymph nodes and 36 diseased lymph nodes were collected from Department of Pathology of Beijing Friendship Hospital. Histological morphology of HE sections was observed. D2-40 staining of lymph nodes was performed by immunohistochemical Eli Vision method, and immunophenotypic characteristics of D2-40 were observed. Results 1.D2-40 was positive in the submembranous sinus of normal lymph nodes (49 / 54) and negative or weakly positive in the lymphatic sinus (49 / 54). But there were 4 lymph nodes dilated obviously, the endothelial cells proliferated, and a large number of plasma cells gathered around the lymphatic sinus. At this time, the D2-40 staining of lymphatic sinus was strongly positive in the follicular area of normal lymph nodes at 16 / 54). A large number of D2-40 staining positive tubular structures were found in the paracortical region, and these tubules were reported as lymphatic labyrinth. 3. The number of endolymphatic labyrinths in hyperplastic lymph nodes (14 / 54) was more than that in inactive hyperplastic lymph nodes (40 / 54), and the difference was statistically significant (P 0.05). Of 15 metastatic lymph nodes, 15 / 15 lymph nodes were positive for D2-40 staining in the submembranous sinus, and 3 lymph nodes were negative for all lymph sinuses (2 signet-ring cell carcinoma of stomach, 1 carcinoma of undetermined type, surrounded by lymphatic labyrinth). Does not destroy the structure of lymph nodes. In 21 lymph nodes of 16 / 18 lymphomas, D2-40 staining was positive in the submembranous sinus of 18 lymph nodes, and lymphatic labyrinth could be seen in 21 lymph nodes with negative lymphatic sinus. However, the quantity and intensity of the staining were not regular. Conclusion 1.D2-40 is expressed not only in lymphatic endothelial cells, but also in lymphatic sinus endothelial cells, especially in submembranous sinus. There are many D 2-40 positive tubular structures in the paracortex of lymph nodes, I. e., lymphatic labyrinth. In this study, D 2-40 staining was used for the first time to confirm the existence of lymphatic labyrinth. 3. The number of endolymphatic labyrinth in proliferative lymph nodes is more numerous. D2-40 staining is stronger. 4. D2-40 immunohistochemical staining shows that lymphatic labyrinth is more practical, simple and effective than traditional scanning electron microscopy, which provides a new method for the study of endolymphatic network in lymph nodes. The study of lymphatic sinus and lymphatic labyrinth by D2-40 is helpful to understand the basic structure of lymph nodes and to better understand the formation of diseases in lymph nodes.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R361

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本文編號：1864196