胃癌细胞增殖活性与脉管转移及预后关系的探讨

Evaluation of the correlations of cell proliferation activity with lymphatic and vascular invasion and prognosis in gastric carcinoma

目的探讨胃癌细胞溴化脱氧脲嘧啶核苷(BrdUrd)标记指数(LI)、G2/M期细胞比率(G2/MPF)、DNA含量与胃癌淋巴管侵袭、淋巴结转移、静脉侵袭及预后之间的关系。方法用BrdUrd/DNA双参数流式细胞术(FCM)检测60例胃癌新鲜标本。碘化丙啶(PI)用于检测细胞DNA的荧光探针,抗BrdUrd单克隆抗体用于掺入DNA中的BrdUrd探针。荧光标记的羊抗鼠抗体用于第二抗体。用体外标记BrdUrd法检测S期比率,同时检测DNA倍体和G2/MPF。结果淋巴管侵袭阳性者BrdUrdLI和G2/MPF均明显高于阴性者(P<0.01),二者5年生存率差异有统计学意义(P<0.01)。淋巴结转移阳性者BrdUrdLI和G2/MPF较阴性者明显增高(P<0.01),二者5年生存率差异有统计学意义(P<0.01)。异倍体癌淋巴结转移阳性者明显增高(P<0.05),二倍体癌的5年生存率较异倍体癌明显增高(P<0.05)。淋巴结多数转移者(>5个)的BrdUrdLI较无转移者(P<0.01)和少数转移者(1～4个)明显增高(P<0.05),G2/MPF较无转移者明显增高(P<0.01);淋巴结少数转移者较无转移者的G2/MPF明显增高(P<0.05),淋巴无结转移、少数转移和多数转移者之间比较,其5年生存率差异有统计学意义(P<0.01);异倍体癌淋巴结多数转移者明显增高(P<0.01)。静脉侵袭阳性的G2/MPF较阴性者明显增高(P<0.01)。结论胃癌细胞BrdUrdLI、G2/MPF、DNA含量和脉管侵袭与胃癌预后有一定的关系。

Objective To evaluate brornodeoxyuridine/DNA （BrdUrd/DNA） double-parametric flow cytometric analysis in detection of gastric carcinoma and to study the correlations of cellular BrdUrd labeling index （LI）, G2/M phase fraction （G2/MPF） and DNA content, with lymphatic and vascular invasion and prognosis. Methods Sixty cases of fresh tumor samples were examined by BrdUrd/DNA double-parametric flow cytometry. Results BrdUrd LI and G2/MPF values were both significantly higher in patients with lymphatic invasion than those without invasion （ P 〈0.01 ）. There was statistically significant difference between the 5-year survival rates in cases with and without lymphatic invasion （ P 〈0.01 ）. Both BrdUrd LI and G2/MPF values were significantly higher in patients with lymph node metastasis than those in cases without metastasis （ P 〈0.01 ）. There was a significant difference in 5-year survival rates between patients with and without lymph node metastases. The incidence of lymph node metastasis was significantly higher in aneuploid carcinoma （ P 〈0. 05）, and the patients with aneuploidy had significantly poor prognosis. BrdUrd LI was significantly higher in patients with more than 5 metastatic lymph nodes than those with 1-4 metastatic lymph nodes （P 〈 0.05） and no metastasis （P 〈 0.01）. G2/MPF values in cases with more than 5 and 1-4 metastatic lymph nodes were higher than that in cases with no metastasis （P 〈 0.01 and P 〈 0.05, respectively）. There were significant differences in 5-year survival rates among patients with no lymph node metastasis, 1-4 nodes metastasis and more than 5 nodes metastasis. G2/MPF values were significantly higher in patients with and without vascular invasion （P 〈 0.01 ） . Conclusion Correlations exist among cellular BrdUrd LI, G2/MPF, DNA content and lymphatic involvement, vascular invasions and prognosis in gastric carcinoma.