頭頸部扁平上皮癌症例における間質反応の臨床的意義

抄録

A total of 71 cases of squamous cell carcinoma of the head and neck were investigated in terms of the existence of a basal membrane, the type and amount of infiltrative cells and blood vessels in the interstitial tissue surrounding tumor. The existence of the basal membrane was investigated using H. E stain, PAS stain, Azan stain and ABC method using anti-human fibronectin antibody. As for the infiltrative cells, the number of cells per 1000μmm³ and the types of cells were investigated using a micrometer. Concerning blood vessels examinations of the endothelium and the basal membrane of the vessels stained by ABC method using anti-factor VIII antibody were reformed. As for clinical factors, recurrence stage, existence of the local or distant metastasis, clinical prognosis, and non-specific immunoparameters including lymphocytes, T cell and B cell populations, etc. were studied. The clinical significance of the interstitial reaction was examined statistically based on the above results.
The amount of infiltrative cells showed a significant positive correlation with the clinical prognosis, immune parameter (Index of PHA × peripheral lymphocyte count), and degree interstitial fibronecrotin stain. The basement membrane of the carcinoma was composed of a collagenic membrane, separated in the interstitial tissue from the carcinoma. The prognosis was remarkably in cases with defects in the basal membrane often due to distant metastasis of the carcinoma, while an intact basement membrane was related to a good prognosis. The condition of the basement membrane also significantly correlated with the increase of fibrin in the interstitial tissue. A variety of vascular changes were observed even within the same histologic type of squamous cell carcinoma. In case with a well-defined basement membrane vessels were abundant.
Immunereaction against the tumor was considered to occur mainly in surround interstitial tissue. It was concluded that interstitial tissue changes would have a clinical significance concerning therapeutic course and evaluation of prognosis in cancer lost.