자궁경부 편평상피암에서 자연발생하는 Apoptosis에 관한 연구

Abstract

The apoptosis, a distinctive type of individual cell necrosis, has been considered to play a complementary but opposite role to mitosis in the regulation of animal cell populations. It can be initiated or inhibited by a variety of environmental stimuli, physiologically and pathologically. Apoptosis seems to appear in either non-neoplastic or neoplastic tissues, even malignant tumors in the state of untreatment or irradiation. This study was carried out to investigate the spontaneous occurrence of apoptosis in squamous carcinomas of the uterine cervix and its mechanisms. Light microscopically, noted were the condensation and fragmentation of individual tumor cells with formation of apoptotic bodies that were frequently phagocytosed by nearby intact tumor cells. They were commonly seen in the neighbourhood of coagulative necrosis. Electron microscopically (TEM and SEM), noted were nuclear condensation, margination toward the nuclear membrane and fragmentation of membrane-bounded apoptotic bodies that were well preserved. The intracellular apoptotic bodies were phagosomes and reduced to electron-dense lysosomal residual bodies. The conclusion obtained was as follow: Apoptosis was found in all cases of squamous carcinoma of the uterine cervix, of which the frequency was higher in tumors of poor differentiation than those of well to moderate differentiation. The process of the apoptosis is considered to pass through the step of formation of the apoptotic bodies, phagocytosis by adjoining tumor cells or histiocytes, and then degradation as lysosmal residual bodies. Key Words: Apoptosis; Squamous carcinoma; Uterine cervix; TEM; SEM

1988년 12월부터 1989년 5월까지 계명대학교 의과대학 산부인과학교실을 내원한 환자중 30예의 자궁경부에서 발생한 편평상피암 조직을 채취하여 광학 및 전자현미경으로 관찰한 결과 다음과 같은 결과를 얻었다. 광학현미경적으로 다양한 형태의 apoptosis가 단독으로 혹은 군집으로 이루면서 종양세포들 사이에서 관찰되었고, 형성된 apoptotic body는 인접한 종양세포나 탐식세포에 의해 탐식되었다. 전자현미경적으로 apoptotic cell은 흔히 핵의 농축과 분쇄를 볼 수 있었고, 세포질내에는 세포소기관들이 형태학적으로 유지되어 있었다. Apoptotic body는 분쇄되어진 핵의 파편들과 비교적 형태가 보존된 세포소기관들을 포함하며 형질막에 의해 둘러싸여 하나의 독립된 막성구조물로 관찰되었다. 이상의 성적으로 저자는 apoptosis가 악성조직에서도 일어나며 분화도가 좋은 편평상피암 조직보다 분화도가 나쁜 편평상피암 조직에서 더욱 높은 빈도로 관찰됨을 알았다. 또한 apoptosis의 진행과정은 apoptotic body의 형성단계와 인접한 종양세포 또는 탐식세포에 의한 apoptotic body의 탐식과정을 거쳐서 소멸되는 것으로 사료된다.