膀胱移行细胞癌核DNA含量检测及其与预后关系的探讨

Measurement of nuclear DNA content of bladder benign and malignantlesions and assessment of its prognostic significance

对膀胱粘膜良、恶性病变进行了核ＤＮＡ含量研究，其中不典型增生（Ⅱ、Ⅲ级），乳头状瘤各５例，移行细胞癌４５例（Ｉ、Ⅱ、Ⅲ级各１５例），正常膀胱粘膜５例。结果显示：正常粘膜，不典型增生主要为２Ｃ细胞，乳头状瘤以３Ｃ为主，且部分不典型增生和乳头状瘤核ＤＮＡ含量与移行细胞癌Ⅰ级相近。提示不典型增生和乳头状瘤中部分病例有恶变可能。移行细胞癌随分级升高而ＤＮＡ含量递增，非倍体、Ｓ期细胞增多，各级间以及与不典型增生和乳头状瘤间相差非常显著（ｐ＜０．０ｌ）。随访结果显示随着分级升高ＤＮＡ含量增加而复发率、死亡率上升，故ＤＮＡ含量检测有助于临床判断预后。

The nuclear DNA content was determined in 5 cases of grade Ⅱ or Ⅲ dysplasia of the mucosal epithelium,5 cases of papilloma and 45 cases of transtional-cell carcinoma(15 cases each of grade I,Ⅱand Ⅲ respectively)of the urinary bladder and that of 5 cases of normal epithelium was also determined to serve as the control.It was found that the DNA pattern was mainly diploid in normal and dysplastic epithelium and triploid in papilloma, Some cells of the dysplastic epithelium and papilloma showed the DNA pattern in supertetraploid and S phase cells.The DNA content of l papilloma was similar to that of grade I transitional-cells carcinoma. The DNA pattern of aneuploid and S phase cells were increased along with the increasing of the grade of transitional-cells carcinoma. The value of DNA content was significantly different among grade I,Ⅱand Ⅲ transitional-cell carcinoma and was significantly higher in transitional-cell carcinoma than in dysplasia and papilloma( P<0.01).The rate of recurrence and mortality became higher along with the increasing of the grade of the carcinoma and of its DNA content It is believed that the determination of the DNA content of the bladder lesions is of significance for the prognosis of the lesions.