多发胃癌胃切除范围的研究  

Study on extent of resection for multiple gastric carcinoma

作　　者：胡祥[1] 毕伟[1] 安伟德[1] 刘革[1] 吴功侃[1] 

机构地区：[1]大连医科大学第一临床学院普通外科,116011

出　　处：《中华胃肠外科杂志》2002年第1期17-19,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的明确多发胃癌的合理胃切除范围。方法应用组织病理学、免疫组织化学方法,检测多发早期胃癌及背景黏膜上分布的异型增生病变的分布状态、增殖细胞核抗原(PCNA)阳性细胞和癌抑制基因产物变异型P53蛋白的阳性率。结果分化型多发早期胃癌与其背景黏膜上的异型增生病变的分布一致,异型增生病变的PCNA阳性细胞率(30.3%)显著高于正常黏膜及肠上皮化生黏膜(7.8%,21.0%),且高度异型增生病变的PCNA阳性细胞率(38.9%)与癌(44.1%)相近。与此同时,变异型P53蛋白在异型增生病变中被发现,并随其异型程度的增加而升高。结论分化型多发胃癌及具有高度癌变潜能的异型增生病变主要分布于幽门腺、中间带领域。因此,多发胃癌切除时应将幽门腺领域、中间带领域一并切除。Objective To clarify the rational extent of resection for multiple gastric cancer. Methods Stomach specimens were cut serially for histological examination and immunohistochemical staining in proliferative cellular nucleus antigen(PCNA)and P53 protein. Results A high incidence of dysplasia in side of carcinoma was observed. Dysplasia showed high proliferative activity (30 3%). Severe displasia and dysplasia adjacent to cancerous lesion demonstrated the same PCNA positive rate as did cancerous lesion. The P53 expression was positive not only in cancerous lesion but also in dysplasia.Conclusions Dysplasia has a great potentiality for malignant transformation. Rational safety extent of resection for multiple gastric cancer should include pylorous gland zone plus median zone.

关 键 词：增殖细胞核抗原 蛋白质P53 胃癌 组织病理学 免疫组化 

分 类 号：R735.2[医药卫生—肿瘤]