Metastasis via Peritumoral Lymphatic Dilation in Oral Squamous Cell Carcinoma
김한석, 박영욱,
소속 상세정보
김한석 ( Kim Han-Seok ) - Gangneung-Wonju National University College of Dentistry Department of Oral and Maxillofacial Surgery
박영욱 ( Park Young-Wook ) - Gangneung-Wonju National University College of Dentistry Department of Oral and Maxillofacial Surgery
KMID : 1036320140360030085
Abstract
Purpose: Nodal metastasis is the main prognostic factor in the patients with oral squamous cell carcinoma (OSCC). We investigated the association between tumor-associated lymphatics and OSCC characteristics.
Methods: Thirty-four specimens were used for the immunohistochemical staining with the antibody for vascular endothelial growth factor (VEGF)-C, VEGF-D, VEGF receptor (VEGFR)-3, phosphorylated VEGFR-3, D2?40, and matrix metallproteinases (MMPs). We observed the distribution of the lymphangiogenic factors and quantified the degree of expression. We determined lymphatic vessel density (LVD) and lymphatic vessel dilatation with D2?40 immunostaining. We assessed the association of LVD or lymphatic vessel dilatation with tumor progression or tumor differentiation.
Results: OSCC cells expressed lymphangiogenic ligands. Lymphangiogenic receptor, VEGFR-3, was expressed and activated in some tumor cells as well as in tumor-associated endothelial cells. LVD was not associated with tumor size or nodal status, but lymphatic vessel dilatation was higher in tumors with nodal metastasis, and also higher in poorly differentiated tumors. In stromal area of OSCC, MMP-1 and MMP-10 were up-regulated and the basement membrane of tumor-associated endothelial cells was destroyed by these collagenases.
Conclusion: In the primary tumors with nodal metastasis, especially in poorly differentiated OSCC, tumor cells invaded the dilated lymphatic vessels via ruptured sites. MMP-1 and MMP-10 are important in the lysis of the glycocalyx inside the tumor-associated lymphatic endothelial cells.
키워드
Oral squamous cell carcinoma; Lymphangiogenic factor; Nodal metastasis; Lymphatic vessel density; Lymphatic vessel dilation
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