核形态测量对判断小肝癌预后和复发的意义  

NUCLEAR MORPHOMETRY FOR PROGNOSIS AND RECURRENCE OF SMALL HEPATOCELLULAR CARCINOMA

作　　者：赵文和[1] 冯懿正 丁伟[1] 周水云[1] 

机构地区：[1]浙江医科大学附属第一医院肿瘤外科,浙江医科大学附属第一医院病理科,浙江医科大学基础医学院形态中心

出　　处：《浙江医科大学学报》1996年第4期162-164,共3页

摘　　要：作者应用ＭＩＰＳ－１型自动图像分析仪，检测２５例小肝癌细胞核形态学参数及ＤＮＡ含量。结果发现，随着小肝癌细胞分化程度的减低（Ｅｄｍｏｎｄｓｏｎ分级Ⅰ～Ⅲ级），肿瘤细胞核面积、最大直径、积分光密度呈增高趋势，术后复发率逐渐增高（０％、３８．９％、８０％）。复发组肝癌细胞核周长、核最大直径、核积分光密度及ＤＮＡ指数均明显高于未复发组，分别为２５．８４±２．０７比２４．０５±２．７８，８．３８±０．８７比７．７３±０．８１，７．９７±１．８１比５．６５±２．０１，３．０６±１．１１比２．０１±０．５２（Ｐ＜０．０５～０．００５）。结果表明，细胞核增大程度是反映肝癌细胞分化度与恶性度的有效指标。Ｅｄｍｏｎｄｓｏｎ分级对判定肝癌细胞分化程度及预后具有临床实际意义，但核形态参数与ＤＮＡ指数比较，后者在判定分化程度及复发、预后方面更具明显优势。Feulgen stained histologic slides of twenty-five cases of small hepatocellular carcinoma (sHCC)and four cases Of normal liver were submitted to morphometric and DNA index analysis using the image analyzing system. The results showed that when the differentiation of sHCC became poorer (Edmondson grade Ⅰ to Ⅲ), the nuclear area, nuclear maximun diameter, integrate optical density(IOD)tended to go higher and the recurrent rate increased as well (Edmondson grade Ⅰ 0%, Ⅱ 38.9%, Ⅲ 80% respectively). The nuclear perameter, maximum diameter,IOD and DNA index in recurrent cases were all significantly higher than those in the non-recurreht cases. The authors suggest that the increased cell nuclear area might be an effective factor to tell HCC differentiation and malignancy degree; Edmondson grade in determing differentiation and prognosis of HCC is still a practical clinical indicator. Compared with nuclear morphologic parameter in detecting differentiation and analysis of recurrence and prognosis,DNA index seems to have a obvious superiority.

关 键 词：肝肿瘤 细胞核 病理学 形态测定法 预后 DNA 

分 类 号：R735.707[医药卫生—肿瘤]