青年人结直肠癌DNA错配修复基因表达和DNA倍性检测  

The expression of DNA mismatch repair genes and detection of DNA ploidy in young patients with colorectal carcinoma

作　　者：谢丹[1] 梁雪儿[2] 曾薇芬[1] 张萌[1] 陈淑仪 袁兆灿 文剑明[1] 

机构地区：[1]中山医科大学病理学教研室,广州510089 [2]香港大学病理系

出　　处：《中华病理学杂志》2000年第6期412-415,共4页Chinese Journal of Pathology

基　　金：香港"中华人民共和国学者Mrs lvy Wu研究基金"资助项目(1999~2000.NO7)

摘　　要：目的　探讨青年人结直肠癌的临床病理特点和致癌途径。方法　应用免疫组织化学(SABC)法和流式细胞学方法对 6 3例广东籍青年人结直肠癌中hMSH2 和hMLH1 蛋白表达和DNA倍性进行检测 ,结合临床病理学资料 ,分析它们之间的相关性。结果　广东籍青年人结直肠癌患者占中山医科大学第一附属医院接受手术的 12 6 2例广东籍结直肠癌患者的 5 .6 %。6 3例结直肠癌中 ,有 44例 (6 9.8% )为非粘液型腺癌 ,39例 (6 1.9% )肿瘤处于DukesC或D期。 5 9例同时进行免疫组织化学和流式细胞学检测的结直肠癌中 ,有 10例 (16 .9% )丢失了hMSH2 或hMLH1 蛋白 ,全部为二倍体或近二倍体的DNA含量 ,2 6例 (4 4.1% )结直肠癌为非整倍体DNA含量 ,均呈 2种错配修复蛋白的正常表达 ;另外还有 2 3例 (39 0 % )结直肠癌既表现为二倍体或近二倍体的DNA含量 ,又表达正常的hMSH2和hMLH1 蛋白。结论　广东籍青年人结直肠癌患者在全部结直肠癌患者中的比率明显高于白种人系为主的地区 ,约 70 %的青年人结直肠癌为传统的腺癌。 39%的青年人结直肠癌既不沿染色体不稳定途径发展 ,又无证据表明与微卫星稳定性途径有关 。Objective To investigate the clinicopathologic characters and carcinogentic pathways of young (age<36) colorectal carcinomas (CRCs) in Guangzhou, China. Methods Immunohistochemistry and flow cytometry methods were used to detect the expression of hMSH 2 and hMLH 1, status of DNA ploidy in 63 cases of young CRCs from Guangzhou, China, and analyze their correlations with patient's clinicopathological characters. Results Of the 63 young CRCs studied, forty-four (69.8%) tumors were non-mucinous carcinomas, thirty-nine (61.9%) patients were in Dukes' C or D stage. Of the 59 CRCs which were successfully detected by immunohistochemistry and flow cytometry, ten (16 9%) CRCs lost either hMSH 2 or hMLH 1 and showed DNA diploid or near-diploid, while twenty-six (44.1%) had aneuploid DNA content and all with the normal expression of hMSH 2 and hMLH 1. In addition, there existed a significant percentage (23/59, 39%) of young CRCs showing no loss of either of these two mismatch repair proteins and having a diploid or near diploid DNA content. Conclusion The overall percentage of young CRCs in Guangzhou is significantly higher than those in Caucasian predominant countries and about seventy percent of young CRCs in Guangzhou are conventional carcinomas. 39% of young CRCs in Guangzhou showed no evidence of either chromosomal instability or microsatellite instability carcinogentic pathway, indicating that there must be at least a third pathway which triggers the CRCs in these special subgroups of young patients in Guangzhou, China.

关 键 词：结肠直肠肿瘤 突变 免疫组织化学 流式细胞术 

分 类 号：R735.3[医药卫生—肿瘤]