喉頭癌の電子顕微鏡学的研究

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概要

• 論文の詳細を見る

• The laryngeal cancers show an almost uniform histological pattern in comparison with the cancer in other organs. Of these tumors, 99.7% are classified as squamous carcinoma. Histo-pathological study of this cancer has been mainly focused around the grade of malignancy and the mode of the spreading. Electron microscopic studies are rare.In the present study, 30 cases of laryngeal cancers (20 supraglottic and 10 glottic cancers) were studied by electron microscopy. The tumor tissues taken at surgical operation were fixed in 2.5% glutaraldehyde and 2% osmic acid, and dehydrated with the ethanol, and embedded in Epon 812 resin. Ultra-thin sections were doubly stained and examined with an HU-12 electron microscope.Except one case of adenocarcinoma (supraglottic), they were classified histologicaly as to grade of malignancy (Grade I-III).Findings obtained include:Squamous cell carcinomas were classified into 3 groups in view of the mode of their inter-cellular junction. These included the interbridge type (consisting mainly of the desmosome), octopus-like projection type (the cytoplasmic processes were entangled each other), and the intermediate type. In cases of Grade III, no interbridge type was found and desmosomes were found infrequently.The grade of histological malignancy was found to be correlated with electron microscopic findings of nucleus and cytoplasm as for the appearance of heterochromatin and nucleolar nu-cleolonema, and atypia of the nucleus, and development of mitochondria, polysomes and of tonofilaments in the cytoplasm.As to the coutinuity of basement membrane, the electron microscopic classification could be made from Type 1 (no defect of the membrane) to Type 4 (no basement membrane). All cases of Grade III were classified as Type 4.No adenoacanthoma was found in the present study. In no cases, virus like particle was observed.Papillary adenocarcinoma showed the solid proliferation and formed canaliculi with a large number of microvilli. In the cytoplasm of tumor cells in this case, secretory granules of high electron density were found, but no tonofilaments were observed.The direct neoplastic change of the ciliated epithelium and glandular epithelium was found to be extremely rare.In conclusion, the electron microscopic observations were correlated to the grade of his-tological malignancy. Findings of the basement membrane seem to be an useful index for the spreading of laryngeal tumors.It is assumed that the squamous cell carcinoma of the larynx developes tfrom the epithelium through the stage of the squamous metaplasia.

• 社団法人 日本耳鼻咽喉科学会の論文

著者

• 宮原 裕

  大阪大学医学部耳鼻咽喉科学教室

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