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目的利用双重免疫组化染色技术研究胰腺癌神经丛微转移机理。方法我院2006年1月至2007年1月期间对44例胰腺导管腺癌患者施行胰腺癌扩大根治术,采用D2-40和CK19双重免疫组化染色方法,对胰周神经丛中淋巴管微转移、周围神经丛侵犯等进行观察。结果 D2-40标记淋巴管呈棕黄色管腔样结构。胰周神经丛组织内淋巴管多与血管及神经束伴行,而胰周神经束附近的淋巴管均呈明显管腔样结构。CK19染色使胰腺癌细胞胞浆呈红色,清晰显示毛细淋巴管内肿瘤细胞侵犯现象。胰周神经丛侵犯30例(68.2%),21例(47.7%)在胰腺癌周围神经丛组织中的淋巴管内发现肿瘤细胞侵犯,胰周神经侵犯现象与其中的淋巴管侵犯现象存在明显相关性(P=0.003)。结论应重视胰腺导管腺癌术中对可能受侵的神经丛,尤其是肠系膜上动脉周围神经丛的廓清。此外,联合D2-40和CK19的双重免疫组化技术为研究胰腺癌周围神经丛微转移机理提供了新的方法。
Objective To study the micrometastasis mechanism of plexus in pancreatic cancer by double immunohistochemical staining. Methods Forty-four patients with pancreatic ductal adenocarcinoma underwent extended radical mastectomy from January 2006 to January 2007 in our hospital. Using double immunohistochemical staining of D2-40 and CK19, Metastasis, peripheral nerve plexus violations were observed. Results D2-40 labeled lymphatic vessels were brown-colored lumen-like structure. Peri-lymphatic vessels in the peripancreatic plexus were associated with vascular and nerve bundles, while the lymphatic vessels near the peripancreatic nerve bundle showed obvious luminal-like structures. CK19 staining makes the pancreatic cancer cells cytoplasm red, clearly shows the capillary lymphatic tumor cells invade the phenomenon. Pancreatic peripheral nerve plexus invasion in 30 cases (68.2%), 21 cases (47.7%) in pancreatic cancer peripheral lymphatic plexus in the lymphatic vessels found tumor cell invasion, peritival nerve invasion and lymphangiogenesis there is a significant correlation (P = 0.003). Conclusions Should pay attention to pancreatic ductal adenocarcinoma of the possible invasion of the nerve plexus, especially the superior mesenteric artery plexus clearance. In addition, the combination of D2-40 and CK19 double immunohistochemistry provides a new method for studying the mechanism of micrometastasis in the peripheral nerve plexus of pancreatic cancer.