진행된 후두 편평상피세포암에서 기저막 고유성분 중 Liminin과 Type Ⅳ Collagen의 분포에 관한 연구

초록

Degradation of basement membrane is the first step in invasion and metastasis of malignant tumors. Invasive carcinoma shows that the components of basement membrane may be destructed and deposited, possibly resulting from the interaction of tumor cells and extracelluar matrix. Quantity of basement membrane components surrounding the tumor has been reported, comprising of differing cell types, degrees of histopathologic differentiation, presence or absence of metastasis, and prognosis. In reports on squamous cell carcinoma of the larynx, immunohistochemical studies on distribution of basement membrane components showed relationships to varing stages and histopathologic grades. However. the study related to clinical features has not been reported in squamous cell carcinoma of the larynx. In this study, immunohistochemisty was used to detect laminin and type Ⅳ collagen in 47 cases of advanced squamous cell carcinoma of the larynx who have undergone total laryngectomy and neck dissection. Patterns of the basement membrane components were compared to histopathologic grades, invasion modes of tumor, primary sites of tumor, stages of primary tumor, presence or absence of cervical metastasis, and 3-year survival rates. The following results were obtained. 1) The distribution of laminin and type Ⅳ collagen in all cases showed identical pattern. 2) The histopathologic grades of primary tumor have no statistical correlation with patterns of basement membrane components. In invasion modes of primary tumor, the cases with diffuse invasion showed more destuctive patterns than cases with well defined border or cord-like invasion. 3) In sites of primary tumor, the cases with supraglottic cancer showed more destructive patterns than cases with glottic cancer. But, stages of primary tumor have no statistical correlation with patterns of basement membrane components. 4) In presence or absence of cervical metastasis, the cases with cervical metastasis showed more destructive patterns than cases with absence of cervical metastasis. 5) The 3-year survival rate was significantly higer in the cases of preservative pattern than cases with intermediate ordestructive pattern. The above results indicated that the distribution of laminin and type Ⅳ collagen in advanced squamous cell carcinoma of the larynx can be useful in predicting characteristics of the tumor, cervical metastasis and prognosis.