Lamininの免疫組織化学による直腸癌の神経浸潤 Assessment of Neural Invasion in Rectal Cancer by Immunohistochemical Laminin Staining

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直腸癌神経浸潤の同定,判定に基底膜の構成成分であるlamininを用いた免疫組織学的染色を行った.Laminin染色では神経線維束や神経周膜が明瞭に染色され,従来の染色法では観察が不可能であった微小な神経浸潤が正確に判定できた.神経浸潤陽性率は47.8%であった.神経浸潤は壁深達度,静脈侵襲およびリンパ節転移と強い関係を認めた.直腸癌局所再発は157例中26例(16.6%)に認め,神経浸潤陽性では75例中20例(26.7%)であり,陰性では82例中6例(7.3%)であった.7年生存は神経浸潤陽性39%,陰性77%であり有意差を認あた.さらに神経浸潤は局所再発や予後に重要な影響を与え,とくに神経周囲間隙型が予後を左右する重要な浸潤形式であることが明らかになった.Laminin染色を用いて神経浸潤を詳細に検討することは,術前術後の補助療法や自律神経温存手術の適応を決定するうえで意義があると考えられた.

When laminin, a constituent of the basement membrane, was used for the evaluation of neural invasion in rectal cancers, reliable results were obtained. Laminin staining was very useful for the evaluation of neural invasion, because staining of the perineurium and nerve fascicles was more distinct than that of other staining methods, including hematoxylin-eosin, silver-impregnation and S-100. The incidence of positive neural invasion in laminin staining was 47.8%. Moreover, neural invasion was strongly correlated with the depth of invasion, venous invasion and lymph node metastasis. Local recurrence was found in 16.6% (26/157) of the cases. A significantly higher frequency of local recurrence (26.7%) was observed in neural invasion positive cases, compared with neural invasion negative cases (7.3%). The 7-year survival rate for neural invasion negative cases (77%) was significantly higher than that for neural invasion positive cases (39%). Neural invasion may be an important prognostic factor which influences both recurrence and the survival rate, particularly in cases of cancer cell infiltration into the perineurium. Using laminin staining, the evaluation of neural invasion may be useful in the determination of pre- and postoperative adjuvant therapy as well as indication of autonomic nerve preserving operation

収録刊行物

  • 日本大腸肛門病学会雑誌

    日本大腸肛門病学会雑誌 50(2), 87-100, 1997-02-01

    The Japan Society of Coloproctology

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各種コード

  • NII論文ID(NAID)
    10008438746
  • NII書誌ID(NCID)
    AN00195100
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    00471801
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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