胆囊腺癌和腺瘤细胞核形态学计量和PCNA定量分析

Nuclear morphometry and PCNA analysis of adenoma and carcinoma in gallbladder

目的研究胆囊腺瘤和腺瘤恶变与胆囊腺癌的关系。方法用 TJTY-300全自动图像分析仪测定了25例胆囊腺癌,20例胆囊腺瘤和3例正常的胆囊上皮 DNA 含量,并用 ABC 免疫组化法对 PCNA 进行了测定。结果 (1)细胞核 DNA 含量、异型性和 PCNA 指数在正常胆囊上皮-异型增生-腺瘤恶变-胆囊腺癌中逐渐增加。(2)胆囊腺瘤中异倍体比例与胆囊腺瘤的大小、合并胆囊结石有明显的关系(P<0.05),而与腺瘤数目、组织学类型无关。PCNA 指数与腺瘤的大小有关,与腺瘤数目及组织学分类无关。结论胆囊腺瘤具有明显的癌变潜能,腺瘤的直径≥1 cm 和伴有胆囊结石时癌变机率更大,应早期手术治疗。

Objective To make clear the relationship between adenoma,malignant transformation of ade- noma and carcinoma in gallbladder.Methodes The nuclear morphometry was performed with a TJTY-300 Auto- matic Image Analyser and PCNA was measured with immunohistochemisty in 25 cases of carcinoma,20 cases of adenoma and 3 cases of normal gallbladder.Results (1) Cell DNA content,atypia and PCNA index were in- creased gradually from the normal cell to dysplasia to malignant transformation of adenoma to carcinoma in gallblad- der;(2) Aneuploidy in gallbladder adenoma and PCNA index had significant relationship to the size of adenoma and gallstones (P<0.05),but did not have relation to the number and histologic type of adenoma.Conclusions Gallbladder adenoma has an obvious tendency to malignant transformation,specially in patients with adenoma of 1 cm or above in diameter and with gallstones.The patients with such high risk should be treated surgically as early as possible.