子宫内膜癌DNA含量及细胞周期时相的研究

AStudyonDNAContentandCelCyclePhaseAnalysisinEndometrialCarcinomaXue

目的：探讨ＤＮＡ含量及细胞周期时相在判断子宫内膜癌预后中的价值。方法：采用流式细胞术对１００例子宫内膜癌的石蜡包埋组织，进行ＤＮＡ含量及细胞周期时相的测定。结果：子宫内膜癌的ＤＮＡ异倍体率为７１．０％。低分化、深肌层浸润及Ⅲ、Ⅳ期的患者，其ＤＮＡ异倍体率均分别高于高分化、无肌层浸润及Ⅰ期患者（Ｐ均＜０．０５）。Ｓ期细胞比率（ＳＰＦ）在低分化（Ⅲ级）、深肌层浸润及Ⅲ、Ⅳ期癌组织中含量也分别高于Ⅰ级、肌层浸润＜１／２及Ⅰ期患者的含量（Ｐ＜０．０１，＜０．０５）。ＤＮＡ异倍体患者的５年生存率为６５．９％，显著低于二倍体患者的８７．６％（Ｐ＜０．０１）。子宫内膜癌死亡患者的ＳＰＦ平均值为１７％。ＳＰＦ＞１７％者的５年生存率为５０．４％，显著低于ＳＰＦ＜１７％者的７９．１％（Ｐ＜０．０１）。ＳＰＦ及分期与预后的关系最为密切。结论：ＤＮＡ异倍体及高的ＳＰＦ值与子宫内膜癌的恶性生物学行为有关，ＤＮＡ倍体及ＳＰＦ是判断预后的重要指标。

Objective:TostudytheprognosticvalueofDNAcontent,celcyclephaseinendometrialcarcinoma.Methods:DNAcontentandcelcyclephaseanalysiswereperformedon100paraffin-embeddedarchivalspecimensfrom103casesofendometrialcarcinomausingflowcytometry.Results:Aneuploidywasfoundin71.0%ofspecimens.TheaneuploidyrateinspecimensfromgradeⅢ,deepmyometrialinvasionandstageⅢ,ⅣwassignificantlyhigherthanthatinspecimensfromgradeⅠ,nonmyometrialinvasionandstageⅠ(P<0.05respectively).5-yearsurvivalrateforpatientswithaneuploidywas65.9%andforpatientswithdiploidywas87.6%(P<0.01).HighS-phasefraction(SPF)wasassociatedwithhighgrade,deepmyometrialinvasionandadvancedstage.ThemeanSPFwas13.4%inthelivinggroupand17%inthedeadgroup.The5-yearsurvivalrateforpatientswithSPF>17%was50.4%andforpatientswithSPF<17%was79.1%(P<0.01).SPFandstagewerethemostimportantprognosticfactorsinendometrialcarcinomabyCox′sproportionalhazardsmodel.Conclusions:DNAploidyandSPFwerefoundtobeofimportantprognosticindicatorsinendometrialcarcinoma.