胃肠道类癌临床病理与免疫组织化学研究

Clinical pathologic and immunohistochemical study of carci- noid in gastro-intestinal tract

应用免疫组织化学ＡＢＣ法，对５２例胃肠道类癌进行８种多肽／胺类神经内分泌激素、２ 种上皮细胞性标记物的研究。结果：胃肠原位激素胰多肽、生长抑素、蛙皮素、胃泌素、五羟色胺较多 表达于组织形态分化好的类型。血管活性肽的表达随肿瘤组织形态分化降低而上升显著（１５．０％、 ２５．０％、５８．３％、Ｐ＜０．０５），并与肿瘤的浸润和转移有关（Ｐ＜０．０５）。异位激素降钙素的表达主要分 布于肿瘤组织形态分化较低的类型（２０．０％、５０．０％、６６．７％、Ｐ＜０．０５）。癌胚抗原的表达随肿瘤组 织形态分化的降低呈大幅度上升（１０．０％、５５．０％、８３．３％、Ｐ＜０．００１），且与肿瘤的浸润有关（Ｐ＜ ０．０５）；神经特异性烯醇化酶与角蛋白的表达与组织分化无相关性。提示应用多种抗原标记对胃肠 道类癌的良恶性判断很有帮助。

Immunohistochemical study was done in 52 cases of carcinoid in the gastro-intestinal tract,using a series of antibodies of 8 kinds of polypeptide of endocrine type and 2 kinds of epithelial type. The rates of antigen express of the GI tract orthotopic hormones, such as HPP,Somatosttin,N-gastrin bombasin,and Serotonin were expressed mainly in the differen- tiation types of the tumor. VIP was expressed mainly in the low - grade differentiation type (15. 0%, 25. 0%, and 58. 3%, P<0. 05 ), and related to deep infiltration and lymphnode metastasis (P<0. 05). Ectopic hormone of GI tract CAT was expressed mainly in the differ- entiation types (20. 0%, 50. 0%,and 66. 7%, P<0. 05 ). The express rate of CEA increased greatly in the low-grade differentiation type (10. 0%, 55. 0%,and 83. 3 %,P<0. 001 ),and related to deep infiltration,There is no relativity between NSE,Keratin and the differentiation of tumor.