62例胰腺癌组织中细胞凋亡的特征

The characteristics of apoptosis in pancreatic cancer: A study of 62 cases

目的研究拟阐明凋亡与胰腺癌分型、分期、分化程度、术后生存期的关系。方法62例胰腺癌标本取自1999年1月至2002年1月中国医科大学第二临床学院普外科及辽宁省人民医院普外科,术后病理证实。22例正常胰腺组织为上述医院的解剖标本。TUNEL法检测正常胰腺组织、胰腺癌组织内的凋亡细胞。结果在22例正常胰腺组织中细胞凋亡率为4/22,程度为(+);在62例胰腺癌组织中细胞凋亡阳性率为72.6%(45/62),程度为(+)～(+++)。凋亡阳性率在胰腺癌组织分型、分期之间无统计学意义;高分化胰腺癌凋亡阳性率高于低分化胰腺癌(P<0.05),中分化胰腺癌凋亡阳性率高于低分化胰腺癌(P<0.01);高、中分化胰腺癌之间差异无统计学意义;在中、高分化胰腺癌中,细胞凋亡程度(++)～(+++)与(-)～(+)的病例术后生存时间比较,前者显著长于后者(P<0.05)。结论凋亡主要影响胰腺癌的发展、转移及预后;细胞凋亡在一定程度上阻止胰腺癌进展,最终延长胰腺癌患者生存时间。因此采用不同方法诱导胰腺癌组织中细胞凋亡可能为胰腺癌综合治疗提供新思路。

Objective To study the association of apoptosis with type, stage phase, degree of differentiation and survival time after operation in pancreatic cancer. Methods Sixty-two tumor samples were gathered from patients of pancreatic cancer in the second clinical college of China Medical University and Liaoning provincial People＇s Hospital during January 1999 to January 2002. Twenty-two cases of normal pancreas tissue were obtained from the above mentioned hospitals. The TUNEL method was used to detect apoptosis in normal and cancerous pancreas tissues. Results The frequency of apoptosis in normal pancreatic tissue was 4/ 22 with degree （＋）. The frequency of apoptosis in pancreatic cancer tissues was 72.6 % （45/62）,with degree of （＋） - （＋＋＋）. The significant difference were not found in association apoptosis with type and stage of pancreatic cancer .The expression of apoptosis in high differentiation pancreatic cancer is higher than that in low differentiation pancreatic cancer （P 〈 0.05）. The expression of apoptosis in middle differentiation pancreatic cancer is higher than in low differentiation pancreatic cancer （P 〈 0.01）. There was no significant difference between high and middle differentiation pancreatic cancer. In high and middle differentiation pancreatic cancer, comparing the patients with apoptosis degree of （＋＋） - （＋＋＋） and with that of （-）-（＋） ,the former had longer survival time than the latter （P 〈 0.05）. Conclusion Apoptosis mainly affect the development,metastasis and prognosis of pancreatic cancer. Apoptosis may inhibit the deterioration of pancreatic cancer in certain extent and resultin, prolong the survival time. Thus adaption of various measures to induce apoptosis may be a new idea in comprehensive treatment of pancreatic cancer.