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Objective: Recent studies have found that the microenvironment of the epithelial cells - mesenchymal epithelial tumors occur not just a passive bystander in the development process, and also plays the role of active participation in, or even a tumor initiator, including interstitial effector cells - fiber mother cells concern because of its important role. A large number of studies have confirmed the existence of a class of activated fibroblasts in tumor stroma, known as tumor-associated fibroblasts (carcinoma-associated-fibroblasts, CAFs) through the secretion of transforming growth factor-β1 (transforming growth factor-β1, TGF -β1) and hepatocyte growth factor (hepatocyte growth factor, HGF) factor to promote tumor development, human primitive hematopoietic cell antigen (hunman hematopoietic the progenitor of cell antigen, CD34) negative, smooth muscle actin-α (Smooth muscle actin- α, αSMA) positive is its main identification mark. Esophageal cancer is one of the most common malignancy in the country, the incidence of serious impact on people's lives and health accounted for 50% of the world, China's focus on prevention and treatment of malignant tumors. Long-term a lot of research to gradually clear the esophageal squamous carcinogenesis → early cancer → advanced cancer for the normal → precancerous lesions. Research on esophageal carcinogenesis, tumor stromal microenvironment, will help resolve the mechanism of carcinogenesis of esophageal squamous epithelium, a strong impetus to the process of prevention and treatment of esophageal cancer, but no reports about the CAFs continuously during carcinogenesis. → early cancer → advanced cancer carcinogenesis process in the expression of α-SMA, CD34, TGF-β1 and HGF interstitial fibroblasts cells from the normal → precancerous lesions in the study observed esophageal stromal CAFs exploration and its related factors TGF -β1 and HGF in esophageal cancer development, and to seek potential clinical significance clinics indicators, provide a scientific basis for the etiology of esophageal cancer, diagnosis, treatment and prognosis. Methods: Immunohistochemistry was used (immunohistochemistry, IHC) streptomycin pro-biotin - peroxidase (SP) was detected in normal group, the low-level intraepithelial neoplasia (CIN) group (moderate dysplasia), high-grade intraepithelial neoplasia change group (severe dysplasia and carcinoma in situ), early cancer group (mucosal cancer) and advanced cancer group of 5 136 cases of esophageal tissue αSMA in expression of CD34, TGF-β1 and HGF, and count each group of microvascular density (microvascular density, MVD), the use of the SPSS13.0 statistical packages for data analysis. Results: 1αSMA in the the esophageal transition process of interstitial fibroblasts express αSMA expression in fibroblasts of normal esophageal tissue expression (0/20), only in muscle cells and vascular wall smooth muscle cells positive. From low-level intraepithelial neoplasia cancer expression gradually increased, reached the highest level to advanced cancer group, expression was 95.7% (22/23). Positive cells were fusiform, ribbon-like was mainly present in the interstitial lesions or cancer nest around. ΑSMA expression of esophageal squamous cell carcinogenesis process of interstitial fibroblasts results showed an upward trend, and its expression was associated with gender, regardless of age, the the αSMA expression of interstitial fibroblasts cells in each group of patients positive rate there is a significant difference (χ ~ 2 = 56.423, P = 0.000). Gradually reduced in the the esophageal transition process of interstitial fibroblasts express CD34 2 CD34 matter fiber cells in the normal esophageal positive expression rate was 95.0% (19/20) from the low-level intraepithelial neoplasia to cancer in each group expressed CD34 only in the group of advanced cancer in vascular endothelial cells positive expression in stromal fibroblasts in cancer around (0/23) did not express. The results showed esophageal squamous carcinogenesis process of interstitial fibroblast CD34 expression on a downward trend, and its expression correlated with sex, regardless of age, the positive rate of CD34 expression in each group of patients a significant difference (χ to 2 = 51.977, P = 0.000). 3 TGF-β1 expression in the process of esophageal epithelial cells and stromal fibroblasts 3.1 TGF-β1 expression of TGF-β1 in the epithelial cells in the normal esophageal epithelial cells was 5% (1/20); The expression rate of grade intraepithelial neoplasia (CIN) group, the group of high-grade intraepithelial neoplasia (CIN), early cancer group, advanced cancer group were 57.7% (15/26), 65.9% (29/44), 43.5% (10/23 ), 13.0% (3/23). Results show that during carcinogenesis of esophageal squamous epithelial cells, TGF-β1 expression was first and then decreased, which peak expression in high-grade intraepithelial neoplasia (CIN) group, and its expression has nothing to do with sex, age, and each group cases significant differences in the expression of TGF-β1 positive rate (χ to 2 = 31.977, P = 0.000). 3.2 TGF-β1 expression of TGF-β1 in stromal fibroblasts in normal esophageal quality in expression (0/20), in the low-level intraepithelial neoplasia group, the group of high-grade intraepithelial neoplasia (CIN), early cancer group advanced cancer group expression rate was 3.8% (1/26), 20.5% (9/44), 34.8% (8/23), 60.9% (14/23). The results show the carcinogenesis of esophageal stroma of TGF-β1 in expression was an upward trend, its expression and patients gender, age has nothing to do, each group of cases of TGF-β1 expression positive rate difference (χ ~ 2 = 31.425, P = 0.000) . 4 HGF expression of HGF fibroblasts in the middle of the process of esophageal quality in normal esophageal stromal expression (0/20), the low level intraepithelial neoplasia (CIN) group, the group of high-grade intraepithelial neoplasia (CIN), early cancer group The expression rates of advanced cancer group were 3.8% (1/26), 28.5% (13/44), 39.1% (9/23), 56.5% (13/23). HGF expression during carcinogenesis of esophageal stromal results showed an upward trend, and its expression has nothing to do with sex, age, the positive rate were HGF expression was a significant difference (χ2 = 26.817, P = 0.000). 5αSMA αSMA and CD34 CD34 and TGF-β1 in esophageal carcinogenesis process quality fiber cell expression correlation analysis between the positive expression of the quality fibroblasts between all levels of lesions in the esophagus has a negative correlation, the correlation coefficient R = -0.762, P = 0.000. of αSMA and a TGF-β1 between lesions of the esophagus at all levels have a positive correlation between the positive expression of the quality fibroblast cells, the correlation coefficient R = 0.419, P = 0.000 esophageal carcinogenesis process stage microvascular density (microvascular density, MVD) The normal esophageal MVD value of 12.33 ± 1.68, low-grade squamous intraepithelial lesion, high-grade intraepithelial neoplasia and early cancer, advanced cancer MVD values ??were 15.72 ± 1.97,20.91 ± 2.20,26.42 ± 1.96,30.01 ± 2.35. The results show the the the cancerous process MVD value gradually increased group MVD values ??significant difference (P = 0.000), and between any two pairwise comparisons were significant difference (P = 0.000). MVD size and the value of the patient's sex and age, αSMA positive group MVD value was significantly higher than the negative group, the MVD value of interstitial TGF-β1-positive group was significantly higher than the negative group. Conclusion: 1 in esophageal squamous epithelium evolution from the normal → precancerous lesions → cancer, stromal fibroblasts to CAFs transformation increase, prompted stromal CAFs may be involved in the malignant transformation of epithelial cells, promoting cancer progression. 2 speculate CAFs through the secretion of TGF-β1 and HGF series of processes involved in esophageal squamous cell carcinoma development. 3 CAFs may promote angiogenesis in the stage of precancerous lesions and thus promote esophageal carcinogenesis and progress. Stromal CAFs secreted factors TGF-β1 and HGF may be an important indicator to predict the outcome of esophageal precancerous lesions.
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