胃肠道平滑肌肿瘤DNA含量与临床病理的关系  

Gastrointestinal smooth muscle tumors:a study of DNA conteut and the association with clinicopathology

作　　者：蔡建辉[1] 蒋贻康[1] 张玉印[1] 张祥宏[1] 吕贵华[1] 高清泽[1] 左连富[1] 

机构地区：[1]河北医科大学附属第二医院外科,河北医科大学附属第二医院病理科

出　　处：《中华病理学杂志》1995年第6期378-380,共3页Chinese Journal of Pathology

摘　　要：应用流式细胞术对８４例胃肠道平滑肌肿瘤的细胞ＤＮＡ含量及其倍体特征进行定量分析。细胞分裂像为０、１、２～４、５～９和≥１０个／１０ＨＰＦ时，异倍体率分别为０，５０％，７５％，９２．８％和１００％（Ｐ＜０．００５）；细胞异形性为０，＋，＋＋和＋＋＋时，异倍体率分别为３．２％，６０％，９５．８％和１００％（Ｐ＜０．００５）。平滑肌瘤３０例无１例异倍体，平滑肌肉瘤４０例均为异倍体，而潜在恶性平滑肌肿瘤１４例中出现４例异倍体（２５．５７％，Ｐ＜０．０１）。肿瘤大径６ｃｍ以上、恶性生长方式、或肿瘤中心有坏死时，异倍体率分别为６４．３％，７９．５％，６８．３％。异倍体肿瘤病人的５年生存率明显低于二倍体肿瘤病人（Ｐ＜０．００５）。结果提示，细胞分裂像在１个／１０ＨＰＦ以上，出现轻度细胞异形性；肿瘤大径≥６ｃｍ、恶性生长方式、或肿瘤中心有坏死时，ＤＮＡ含量均有显著增高，异倍体肿瘤病人预后明显变差。uantitative analysis of DNA content and ploidy pattern was performed in 84 cases of smooth mus-cle tumors of the gastrointestinal tract by flow cytometry, and the results were correlated with histopathologic features. The aneuploid rate was found to be 0, 50%, 75%, 92.8%and 100%respec-tively in the tumors with mitotic figures of 0,1,2～4,5～9, or over10/10 HPF(P<0.005),as to be 3.2%, 60%,95.8%and 100%in tumors with zero,mild, moderate or severe cellular atypia(P<0.005).There were no aneuploidy in the 30 cases of leiomyomas, but all 40 cases of leiomyosarco-mas were aneuploidy,while in the 14 potentially malignant smooth muscle tumors, there were 4 cases of aneuploidy(P<0.01).The aneuploid rate was significantly higher in tumors with contiguous organ in-veasion or distant metastasis (79.5%), and in tumors of large size(64.5%)as well as in tumors with center necrosis(68.3%). 5 year survival rate in patients with aneuploid tumors(41.6%)was signifi-cantly lower than those with diploid tumors(96%)(P<0.005). The results suggested that DNA con-tent and ploidy pattern be used as an objective parameter to distinguish malignants from benigns and pre-dict the prognosis of patients with gastrointestinal smcoth muscle tumors.

关 键 词：平滑肌瘤 脱氧核糖核酸 胃肿瘤 肠肿瘤 病理 

分 类 号：R735.202[医药卫生—肿瘤] R735.302[医药卫生—临床医学]