关于大肠癌内分泌细胞及其分泌激素意义的研究

Significance of endocrine cells and their hormones in colorectal cancer

目的了解内分泌型癌细胞（ＥＣ）及其分泌的部分激素在大肠癌中的表达，探讨其与大肠癌临床病理及预后的关系。方法应用免疫组化法对１１７例大肠癌中嗜铬蛋白Ａ（ＣＧＡ）及５种激素进行检测，其中１３例行电镜观察。结果４６例（３９．３％）含有ＣＧＡ阳性细胞（即ＥＣ），其中３９例中２７例（６９．２％）检测到１种以上激素，ＥＣ阳性组淋巴结转移的发生率（６３．０％）高于阴性组（３９．４％）（Ｐ＜０．０５），中低分化癌组ＥＣ（＋＋）的表达率（２５．５％）明显高于高分化癌组（６．９％）（Ｐ＜０．０５），含ＥＣ的大肠癌生存期短，是评估预后的一个独立因子。激素５－ＨＴ、β－ＨＣＧ、ＧＬＵ、ＧＡＳＴ阳性的癌组织，分化及预后较差（Ｐ＞０．０５）。电镜观察与免疫组化检测大肠癌ＥＣ符合率达９２．３％。结论部分大肠癌中含分泌某些激素的ＥＣ，ＥＣ阳性的大肠癌组织分化差，易发生淋巴结转移，预后不良，可能与ＥＣ中某些激素产物促进肿瘤生长转移有关。

Objective To analyse the expression and clinical pathologic significance of endocrine cell (EC) and their hormones in colorectal cancer (CC).Methods Chromograin A (CGA) and five kinds of hormones in 117 cases of CC were detected by immunohistochemistry with 13 observed by electron microscopy. Results CGA positive cells (EC) occurred in 46 cases (39.3%). 69.2%(27/39) expressed more than one hormone. The lymph node metastasis rate (68.0%) in the EC positive CC was higher than EC negative CC (43.7%) ( P <0.05). The incidence of EC(++) in CC with morderative and poor differentiated (25.5%) was higher than well differentiated ( P <0.05). EC positive CC gave shorter survival. It's an independent factor for evaluating prognosis in CC. The expression of 5 HT, GLU, GAST and β HCG occurred more offen in tumor with moderate and poor differentiation giving poor prognosis ( P <0.05). Cancer cells containing endocrine granules were found in 8 cases of CC by electron microscopy. The two methods were comformable in 92.3%. Conclusion EC positive CC has poor histological differemtiation, giving rise to more lymph mode metastasis and poor prognosis. Some hormones secreted by EC could partly account for the growth and metastasis of CC.