胃肠道平滑肌肿瘤rasp21及DNA与预后的关系

Quantitation of Ras p21 oncogene and DNA content ofgastrointestinal smooth muscle tumors and prognosticsignificance

作者应用细胞免疫荧光染色技术及流式细胞术对５５例胃肠道平滑肌肿瘤石蜡包埋标本的ｒａｓｐ２１表达及ＤＮＡ含量同时进行定量分析。结果：１４例平滑肌瘤均为二倍体和ｒａｓｐ２１低表达；１２例潜在恶性平滑肌肿瘤出现４例异倍体（３３％），９例ｒａｓｐ２１过度表达（７５％），并且大多数出现在该组的二倍体肿瘤中；２９例平滑肌肉瘤全部为异倍体（１００％）（Ｐ＜０．００５），而ｒａｓｐ２１过度表达率未见继续增高（７２％）（Ｐ＜０．００５）。３３例异倍体肿瘤的ｒａｓｐ２１过度表达率（７３％）明显高于２２例二倍体肿瘤（２７％）（Ｐ＜０．００５）。ｒａｓｐ２１低表达的二倍体肿瘤预后最好，ｒａｓｐ２１过度表达的异倍体肿瘤预后最差（Ｐ＜０．００５）。作者认为，ＤＮＡ异倍体及ｒａｓｐ２１过度表达均是恶性肿瘤的标志；ｒａｓｐ２１过度表达主要出现在恶性肿瘤的早期，并且持续稳定的表达；ｒａｓｐ２１表达和ＤＮＡ含量可以互补作为判断胃肠道平滑肌肿瘤患者预后的客观指标。

Abstract Expression of ras p21 oncogene and DNA contentof paraffin-embedded tissues from 55 smooth muscletumors of the gastrointestinal tract were analysed si-multaneously by using immunofluorescence and flowcytometry. All of 14 leiomyomas were found to beDNA diploid and lower-expression of ras p21.Fourcases of DNA aneuploidy(33%)and 9 cases of ras p21overexpression(75%)were found in 12 potential ma-lignant smooth muscle tumors, while all 29 cases ofleiomyosarcomas were aneuploidy(100%)(P<0.005) , but the rate of ras p21 overexpression was notincreased continuously (72%)(P<0.005). 24 of 33aneuploid tumors(73%)were found to be ras p21overexpression, while in 22 diploid tumors, there wereonly 6 cases (27%)(P<0.005).The outcome of thepatients with ras p21 lower-expressed diploid tumorwas excellent,compared to the patients with ras p21overexpressed aneuploid tumor it was worst(P<0.005). It was suggested that DNA aneuploidy and rasp21 overexpression could be regarded as the mark ofmalignancy. The overexpression of ras p21 oncogenewas always presented in the early stage of malignantsmooth muscle tumors, when the cell proliferation wasactive but the DNA content was still normal. and sta-ble in the whole procss of the tumor progression. rasp21 expression and DNA content could supply a defi-ciency each other in the diagnosis and could be used asoUective parameters in distingushing malignancy frombenign and predicting the prognosis of the patientswith smooth muscle tumors of the gastrointestinal tract.