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

【摘要】：目的探索D2-40在正常淋巴結及病變淋巴結的表達特征并總結其規(guī)律。方法收集北京友誼醫(yī)院病理科正常淋巴結54枚、病變淋巴結36枚,觀察HE切片組織形態(tài),應用免疫組織化學Eli Vision法對淋巴結行D2-40染色,觀察D2-40免疫表型特征。結果1.D2-40在正常淋巴結被膜下竇呈陽性(49/54),淋巴竇呈陰性或弱陽性(49/54)。但有4枚淋巴結淋巴竇明顯擴張,竇內皮細胞增生,淋巴竇周圍可見大量的漿細胞聚集,此時淋巴竇D2-40染色強陽性。2.D2-40在正常淋巴結(16/54)的濾泡間區(qū)、副皮質區(qū)可見多量D2-40染色陽性的管狀結構,這些小管即為文獻報道的淋巴迷路。3.增生活躍的淋巴結(14/54)較增生不活躍淋巴結(40/54)內淋巴迷路數(shù)量多,染色強,差異存在統(tǒng)計學意義(P0.05)。4.癌轉移淋巴結15枚,9/15枚淋巴結殘存的被膜下竇D2-40染色呈陽性,淋巴竇均陰性。3枚淋巴結(胃印戒細胞癌2枚,未確定類型癌1枚),癌組織被淋巴迷路包圍,并不破壞淋巴結的結構。5.淋巴瘤淋巴結21枚,16/18枚淋巴結被膜下竇D2-40染色呈陽性,淋巴竇陰性。18/21枚淋巴結內可見淋巴迷路,但數(shù)量及染色強度未見明顯規(guī)律。結論1.D2-40不僅在淋巴管內皮細胞表達,也可在淋巴竇內皮細胞表達,特別是被膜下竇。2.淋巴結的副皮質區(qū)存在多量D2-40染色陽性的小管狀結構,即淋巴迷路。本研究首次通過D2-40染色印證了人體淋巴結內存在淋巴迷路。3.增殖狀態(tài)的淋巴結內淋巴迷路的數(shù)量更多,D2-40染色更強。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,為研究淋巴結內淋巴網(wǎng)路提供了新的手段。5.通過D2-40研究淋巴竇和淋巴迷路,有助于更清晰地認識淋巴結的基本結構、更好地理解淋巴結內疾病形成的規(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.
【學位授予單位】：首都醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R361

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