摘要目的 通过对比上皮性原发癌、转移癌与其癌栓的组织形态学及E-cadherin和波形蛋白表达情况,从组织学水平探讨癌细胞在侵袭、转移过程中是否遵循上皮-间质转化(EMT)机制.方法 59例经病理诊断证实的原发性腺癌或原发性鳞状细胞癌及其淋巴结转移癌患者的68个石蜡组织标本,其中高分化癌组织13例,中分化癌11例,低分化癌30例,淋巴结转移癌14例,每例均有血管内或淋巴管内癌栓.挑选同一切面上同时具有癌组织(包含原发癌或淋巴结转移癌)及癌栓的蜡块进行HE染色观察形态及免疫组织化学(SP法)检测E-cadherin和波形蛋白表达.结果 癌组织与癌栓具有相似的形态学特征；54例原发性癌组织E-cadherin和波形蛋白阳性分别为50和23例,其癌栓阳性分别为51和22例,经统计学分析两者的E-cadherin和波形蛋白表达差异无统计学意义(P =0.804,P=0.842)；14例淋巴结转移性癌组织E-cadherin和波形蛋白阳性分别为12和6例,其癌栓E-cadherin和波形蛋白阳性分别为12和7例,两者的E-cadherin和波形蛋白表达差异无统计学意义(P=0.084,P=0.878)；癌组织和癌栓的E-cadherin和波形蛋白表达差异无统计学意义(P=0.410,P=0.824)；癌栓部分癌细胞高表达E-cadherin而波形蛋白缺失,部分癌细胞高表达波形蛋白而E-cadherin缺失.结论 原发癌及其淋巴结转移癌、癌栓三者EMT特征无显著差异；癌栓细胞既有EMT细胞也有非EMT细胞,它们在肿瘤转移过程中的作用尚待进一步研究.

abstractsObjective To explore whether cancer cells abide by the mechanism of epithelialmesenchymal transition (EMT) in the process of invasion and metastasis by comparing histology and protein expression of E-cadherin and vimentin among primary,metastatic carcinomas and their emboli.Methods A total of 68 tissue specimens in 59 cases of primary adenocarcinoma or squamous cell carcinoma and their lymphatic metastasis were collected,of which there were 13 well differentiated,11 moderately differentiated,30 poorly differentiated tumors and 14 lymphatic metastases.The morphology and the expression of E-cadherin and vimentin proteins were assessed by H-E stain and immunohistochemistry.Results The overall morphology of the primary cancers and their tumor emboli was similar.Among 54 primary cancers,50 cases were positive for E-cadherin and 22 cases were positive for vimentin.Fifty-one cases were positive for E-cadherin and 22 cases were positive for vimentin in the tumor emboli,with no statistical difference (P =0.804,P =0.842).Among 14 cases of lymphatic metastasis,12 cases were positive for E-cadherin and 6 cases were positive for vimentin,and the tumor emboli in 12 cases were positive for E-cadherin and 7 cases were positive for vimentin,with statistical difference (P = 0.084,P = 0.878 ).There were no significant difference of E-cadherin and vimentin protein expression between the cancer tissue and its emboli (P = 0.410,P = 0.824).A subset of tumor cells in cancer emboli expressed E-cadherin at a high level without vimentin expression,whereas other cells in tumor emboli showed an opposite expression pattern.Conclusions There is no significant difference of EMT characteristics among primary cancer,lymphatic metastases and their cancer emboli.Cancer thrombus contains both EMT and non-EMT cells.Further studiesare required to elucidate the role of EMT in the processes of tumor invasion and metastasis.