癌旁移行粘膜P53蛋白表达对判断直肠癌远端切缘的临床意义

Clinical significance of the expression of p53 protein in the transitional mucosa adjacent to rectal cancer

目的检测癌旁粘膜p53蛋白的表达,探讨远端肠壁内浸润的分子长度及其对临床指导意义。方法应用免疫组化方法检测34例直肠癌癌旁移性黏膜中p53蛋白表达。结果(1)直肠癌远端扩散有9例,占29.4%,远端扩散距离均在2 cm以内。(2)34例直肠癌标本其癌组织远端均表现为癌旁黏膜.其癌旁黏膜的距离均未超过4 cm。(3)P53蛋白在癌组织中表达阳性为20例,阳性率为58.6%;在癌旁表达为10例,阳性率为29.3%。结论直肠癌远端肠管移性黏膜2-4厘米处于癌前病变状态,用免疫组化染色较常规HE测量直肠癌远端浸润长度更准确,对指导临床更有意义。

Objective To study the expression of p53 protein in the transitional mucosa adjacent to the rectal cancer,we discuss the affection and elinieal significance of the transitional mueosa adjacent to the cancer in which molecular distance is safe for the distal edge in rectal cancer dissecfion.Methods The immunohistochemical research had shown the expression of p53 protein in transitional mucks adjacent to the cancer. The samples came from the 34 patients who had got dissection for rectal eancer. Results （1） It were 9 samples who had had distal diffused, the ratio is 29.4%. the distance of the distal diffusion were all inner 2 era. （2）All 34 samples of tumor body had the same manifestation,they showed the transitional mueesa adjacent to cancer.In all samples I had studied,the distance of transitional mucosa adjacent to cancer were all inner 4 era. （3） There were 20 samples who got p53 positive in the tumor body,positive rate is 58.6% .The number p53 positive in the transitional mueosa adjacent to the rectal cancer were 10,it is 29.3%. Conclusion There are 2- 4 cm pre-carcinoma patholngieal stage,. It is suggested that the dissection distance of the distal bowel in the rectal cancer should be long enough.. The irnmunohistoehemieal research is more clinical significance than HE examinaition.