直肠癌远侧端粘膜P53的表达及其意义

The expression of P53 and its signification in rectal distal mucosa of rectal cancer

目的:从分子病理学水平上探讨直肠癌的安全远侧切缘。方法:对45例中低位直肠腺癌下缘进行标记;PET/CT检查并结合半定量免疫组织化学方法对直肠癌的远侧端粘膜P53表达进行了研究。结果:直肠癌及远侧端直肠粘膜均可见P53表达,直肠癌肿瘤组织中P53表达明显高于直肠癌远侧端的直肠粘膜组织。直肠癌远侧端粘膜P53表达随着距离增大而减少,但有显著性异常改变只在有限的长度内(直肠远侧端1.5cm),阴性对照中仍有P53的表达。肿瘤组织及直肠远侧端粘膜中P53表达与肿瘤大小、分期以及病理类型无关。结论:切除直肠腺癌远侧1.5cm长度可切除P53明显异常表达的组织,若从分子病理学角度来界定,2cm的直肠远侧端长度是安全的远侧切缘。

Objective： to explore the required distal margin of radical surgery for rectal cancer in molecular pathologic level. Method： The 45 cases of the rectal cancer were marked before operation, and then the cases were detected by PET/CT imaging; P53 expression in rectal distal tissue portion were detected by using immunohistochemical techniques. Resnlts： P53 expression in rectal cancer was significantly higher than that in distal mucosa to cancer margin, which in distal mucosa was decreased along the anal direction, was still founded in the negative control rectal tissue. P53 expression was not significantly different between in more than 1.5era distal rectal mucosa and in negative control rectal tissue, But it in tumor and rectal distal tissue was not associated with size, king and staging of rectal cancer. Conclusion： Excision of 1.5era rectal distal tissue could remove obvious abnormity tissue of P53 expression. From the molecular pathologic point of view, resection of 2.0cm rectal distal tissue should be safe for excision of rectal cancer.