直肠癌及癌前病变中DNA倍体的测定及临床意义  

Determination of DNA ploidy in patients with rectal carcinoma and its precancerous lesion and clinical significance

作　　者：张勇超[1] 

机构地区：[1]河南省肿瘤医院普外科,郑州450003

出　　处：《中华实验外科杂志》2010年第4期461-462,共2页Chinese Journal of Experimental Surgery

摘　　要：目的检测直肠癌及癌前病变细胞内的DNA倍体及DNA指数（DI值），探讨其临床意义。方法应用流式细胞仪（FCM），对320例新鲜直肠组织细胞的细胞核进行DNA倍体测定，其中正常组25例，增生性息肉组25例，绒毛状腺瘤组150例，直肠癌组120例，检测其异倍体检出率和DNA指数。结果直肠癌组的DNA异倍体检出率（76．67％）显著高于正常组（0．00％）、增生性息肉组（0．00％）、无不典型增生的绒毛状腺瘤组（10．00％）及伴轻度（13．33％）、中度（20．00％）、重度（44．00％）不典型增生的绒毛状腺瘤组（P〈0．01），绒毛状腺瘤伴重度不典型增生组的DNA异倍体检出率显著高于正常组、增生性息肉组、无不典型增生的绒毛状腺瘤组及伴轻度、中度不典型增生的绒毛状腺瘤组（P〈0．01）。随着直肠癌的组织学分化程度降低，其DNA异倍体DI值呈增加趋势且差异有统计学意义（P〈0．01）。结论DNA倍体的检测有助于了解肿瘤细胞的增殖及恶性程度，在直肠癌的诊断和鉴别诊断、监测病情变化、判断预后方面均有一定意义。Objective To investigate the clinical significance of DNA ploidy, DNA index （DI） in patients with rectal carcinoma and its precancerous lesion. Methods Flow cytometry （FCM） was used to measure DNA ploidy of the fresh rectal tissues from 320 cases including 120 patients with rectal carcinoma, 25 with proliferative polyp, 150 with villous adenoma and 25 normal controls. The positive rate of heteroploid and DI were analyzed. Results The positive rate of heteroploid in rectal carcinoma （76. 67% ） was significantly higher than that in normal controls （0.00%）, proliferative polyp （0. 00% ）, villous adenoma without atypical proliferation （10.00%） and villous adenoma with mild （13.33%）, moderate （20. 00% ）, severe （44. 00% ） atypical proliferation （P 〈0.01 ）. The positive rate of heteroploid in villous adenoma with severe atypical proliferation was significantly higher than that in normal controls, proliferative polyp, villous adenoma without atypical proliferation, villous adenoma with mild atypical proliferation and villous adenoma with moderate atypical proliferation （P 〈0. 01 ）. When the histological differentiation degree of rectal carcinoma declined, DI of DNA heteroploid was gradually increased （ P 〈 0. 01 ）. Conclusion The determination of DNA ploidy is a valuable index to study the proliferation and malignancy degree of tumor cells. The detection of DNA ploidy may play an important role in the diagnosis, differential diagnosis, assessment of the progression and prognostic judgment of rectal carcinoma.

关 键 词：流式细胞术 直肠癌 癌前病变 DNA倍体 

分 类 号：R735.37[医药卫生—肿瘤]