Abstract:
The aim of this research was the study of proliferative lymphatics microvascular density in
preneoplastic and neoplastic lesions of uterine cervix. Material: squamous metaplasia – (n=22)
cases, CIN I – (n=16), CIN II – (n=14), CIN III – (n=6), microinvasive carcinoma – (n=15),
invasive carcinoma – (n=32). Methods: for histopathologic diagnosis and lesion’s stadialisation
hematoxilin&eosin staining has been used. For identification of general LMVD and density of
proliferative lymphatics the LSAB+/HRP Double Stain technique were performed. Two
monoclonal antibodies have been used: anti D2-40 and anti Ki-67. Weidner hot spot modified
method was used for lymphatic vessels quantification. Results: proliferative lymphatic vessels
density in squamous metaplasia was equal with 0,93; CIN I – 1,4; CIN II – 3,33; CIN III – 4,56;
microinvasive carcinoma – 3,01; invasive carcinoma – 2,14. Intratumoral lymphatics were small,
flattened, without lumen. Peritumoral lymphatics were large, with distinct lumen. In peritumoral
area were found 21 lymphatic vessels with tumor emboli inside, 8 of them were proliferative
lymphatics. Conclusions: preneoplastic and neoplastic lesions of uterine cervix determine active
formation of new lymphatic vessels. Lymphangiogenic switch begins in CIN I stage. In CIN III
stage the LMVD is the highest. The intensity of tumor lymphangiogenesis is not smaller than in
CIN stages. The spreading of tumor cells occurs through both types of lymphatic vessels:
preexisting and newly formed.
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Scopul lucrării a fost studierea densităţii microvasculare limfatice proliferante în leziunile
preneoplazice şi neoplazice de cervix uterin. Material: metaplazie scuamoasă – (n=22) cazuri,
CIN I – (n=14), CIN II – (n=12), CIN III – (n=6), carcinom microinvaziv – (n=15), carcinom
invaziv – (n=32). Metode: hematoxilină şi eozină pentru diagnosticul histopatologic şi
stadializarea leziunilor; dublă imunocolorare utilizând tehnica LSAB+/HRP Double Stain. Au
fost utilizaţi pentru cercetare anti D2-40 şi anti Ki-67. Numărarea vaselor limfatice s-a făcumatut prin
metoda hot spot modificat a lui Weidner. Rezultate: densitatea vaselor limfatice proliferante în
metaplazia scuamoasă este egală cu 0,93; CIN I – 1,4; CIN II – 3,33; CIN III – 4,56; carcinom
microinvaziv – 3,01; carcinom invaziv – 2,14. Limfaticele intratumorale au fost mici, colabate,
iar cele peritumorale – medii sau mari, cu lumen evident. Au fost depistate 8 vase limfatice
proliferante cu emboli tumorali în lumen. Concluzii: leziunile preneoplazice şi neoplazice
determină activ formarea limfaticelor de neoformaţie, switch-ul limfangiogen începe în CIN I şi
atinge apogeul în CIN III. Intensitatea limfangiogenezei tumorale în carcinoamele invazive nu
este mai mică decât în CIN. Metastazarea celulelor neoplazice are loc atât prin limfaticele
preexistente, cât şi prin cele de neoformaţie.
