Author/Editor		Zidar, Nina; Kojc, Nika; Gale, Nina
Title		Diagnostic and prognostic significance of stromal myofibroblasts in laryngeal carcinogenesis
Translated title		Diagnostični in napovedni pomen miofibroblastov pri karcinomu grla
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 71, št. Suppl 3
Publication year		2002
Volume		str. III-49-51
Language		eng
Abstract		Background. Recent studies have shown that stromal reaction in cancer has a more important diagnostic and prognostic significance than previously thought. CD34-positive stromal cells and myofibroblasts may play an important role in host response to invasive cancer. The aim of our studies was therefore to analyze the distribution and immunohistochemical phenotype of stromal cells in epithelial hyperplastic lesions (EHL) and squamous carcinoma (SC) of the larynx, and to establish their diagnostic and prognostic significance. Methods. We investigated samples of 62 resected larynxes with SC, 50 laryngeal biopsies of EHL and SC, and 5 samples of normal laryngeal mucosa. Immunohistochemistry was performed using antibodies against vimentin, a-smooth muscle actin (SMA), desmin, CD34 and leucocyte common antigen (LCA). Results. The stroma of normal laryngeal mucosa and EHL contained scattered CD34-positive cells, but there were no SMA-positive myofibroblasts. In contrast, the stroma of SC contained SMA-positive cells but there were no CD 34-positive stromal cells. We observed two patterns of stromal reaction in SC: one was characterised by a marked proliferation of myofibroblasts and desmoplasia, with scarce lymphocytic infiltration; this pattern tended to be associated with well or moderately differentiated SC. The other was characterised by few myofibroblasts, weak desmoplasia, and dense lymphocytic infiltration; the latter pattern tended to be associated with moderately or poorly differentiated SC. Conclusions. Our studies show that disappearance of CD34-positive cells and appearance of SMA-positive myofibroblasts in the stroma is associated with transformation of laryngeal EHL to SC. This pattern of stromal reaction should be regarded as an additional marker of invasion. Our results also suggest that characteristics of stromal reaction in SC could be of prognostic significance.
Summary		Izhodišča. Novejše raziskave kažejo, da ima stromalni odziv pri invazivnem raku pomembnejšo diagnostično in napovedno vrednost, kot so prvotno domnevali. V odgovoru gostitelja na rakasto raščo igrajo verjetno pomembno vlogo CD34-pozitivne stromalne celice in miofibroblasti. V naših raziskavah smo zato skušali opredeliti razporeditev in imunohistokemične značilnosti stromalnih celic pri epitelijskih hiperplastičnih spremembah (EHS) in ploščatoceličnem karcinomu (PK) grla in ugotoviti njihovo diagnostično in napovedno vrednost. Metode. V raziskavo smo vključili vzorce 62 bolnikov, ki so jim zaradi PK odstranili grlo, in biopsijske vzorce 50 bolnikov z EHS ali PK grla ter 5 avtopsijskih vzorcev normalne sluznice grla. Imunohistokemične preiskave smo opravili s pomočjo protiteles proti vimentinu, a-gladkomišičnem aktinu (GMA), desminu. CD 34 and skupnem levkocitnem antigenu (LCA). Rezultati. V normalni sluznici in pri EHS grla smo v stomi našli razsejane CD34-pozitivne celice, ne pa tudi GMA-pozitivnih miofibroblastov. V stromi PK pa smo našli GMA-pozitivne miofibroblaste, ni pa bilo CD34-pozitivnih stromalnih celic. Pri PK smo opazili dva vzorca stromalnega odziva: za prvega je bila značilnost izrazita desmoplazija s proliferacijo miofibroblastov in pičlo limfocitno infiltracijo; ta vzorec smo opazili predvsem pri dobro do zmerno diferenciranih PK. Za drugi vzorec je bila značilna šibka desmoplazija z redkimi miofibroblasti in intenzivna limfocitna infiltracija strome; ta vzorec smo opazili predvsem pri zmerno do slabše diferenciranih PK. Zaključki. Naše raziskave so pokazale, da je izginotje CD34-pozitivnih celic in pojav GMA-pozitivnih miofibroblastov v stromi povezano s preobrazbo EHS v PK grla. Ta vzorec stromalnega odziva bi lahko uporabljali kot dodatni označevalec invazije. Naši rezultati so tudi pokazali, da imajo značilnosti stromalnega odziva pri PK napovedno vrednost.
Descriptors		LARYNGEAL NEOPLASMS STROMAL CELLS FIBROBLASTS PROGNOSIS CARCINOMA, SQUAMOUS CELL FOCAL EPITHELIAL HYPERPLASIA ANTIGENS, CD34