结直肠癌核仁组成区嗜银蛋白的预后价值

AgNOR, DNA ploidy and prognosis in colorectal cancer

本作者采用银染技术和流式细胞分析技术分别对８３例结直肠癌细胞的核仁组成区嗜银蛋白（ＡｇＮＯＲ）和ＤＮＡ含量进行测定，并结合临床随访和病理学资料评估其预后价值及相互关系。结果显示：结直肠癌组ＡｇＮＯＲ平均计数（９．７９±３．６７０）明显高于正常结肠粘膜组（２．９３７±０．８１２）。不同组织学分级的ＡｇＮＯＲ有显著性差异（ｐ＝０．０２３），分化好的肿瘤ＡｇＮＯＲ计数低。术后生存≥５年组的ＡｇＮＯＲ数（８．１７７±３．２９６）低于＜５年组（１１．６２２±３．１２３），二组间差异显著（Ｐ＜０．００１）。高ＡｇＮＯＲ（≥１０）组患者的术后生存率亦明显低于ＡｇＮＯＲ＜１０组的患者。结合ＤＮＡ倍体进行分析，ＡｇＮＯＲ＜１０的二倍体肿瘤患者的预后最好，而ＡｇＮＯＲ≥１０的异倍体肿瘤的预后最差，提示ＡｇＮＯＲ是一项预后参考指标，与ＤＮＡ从不同水平影响结直肠癌的恶性潜能，联合检测ＡｇＮＯＲ和ＤＮＡ可较好地反映结直肠癌患者的预后。

Abstract A follow-up study with special reference to nucle-olarorganizer region-associated protein (AgNOR)andDNA ploidy was conducted in 83 consecutive cases ofcolorectal cancer patients who underwent radical surg-ery at the people’s Hospital,Beijing, from 1982through 1986.Counting on the mean number ofAgNOR showed a predominant difference between thetumor tissue(9.796±3.670)and normal mucosa(2.937± 0.812),(P<0.001 ).With regard to the tumor differentiation,the number of AgNOR was paral-leled with the degree of malignancy of the tumor,8.178±2.864 for well differentiated tumors,10.086±3. 940for moderatelv differentiated tumors and 11.577 ±2. 824 for poorly differentiated ones. Patients withlower AgNOR(<10)tumor had a prominent survivaladvantage over those with AgNOR≥10 tumor, Partic-ularly when combined with the factors of DNA ploidyand AgNOR , prognosis of patients with diploid tumorand AgNOR < 10 was more favorable than that ofthose with aneuploid and AgNOR≥10 tumor.