大肠癌内分泌样癌细胞的免疫组化研究

Immunohistochemical study on endocrine like tumor cells in colorectal carcinomas

目的研究大肠癌组织中内分泌样癌细胞的表达及其临床意义．方法采用免抗人嗜铬蛋白Ａ（ＣＧＡ）多抗标记的免疫组化ＡＢＣ法，检测１９９１年～１９９６年经１０％福尔马林固定，石蜡包埋的６２例大肠癌手术切除癌组织（男３５例，女２７例，年龄１９岁～７８岁，平均５０３岁；其中直肠癌４４例，结肠癌１８例；ＤｕｋｅｓＡ期１９例，Ｂ期２９例，Ｃ期１４例；有淋巴结转移１４例，无淋巴结转移４８例）中的内分泌样癌细胞的表达，并分析其表达与临床病理、年龄及性别之间的关系．结果大肠癌组织中ＣＧＡ阳性表达２２例（３５５％）；其中非老年组３７例，ＣＧＡ阳性表达１７例（４５９％）；老年组２５例，ＣＧＡ阳性表达５例（２００％），老年组ＣＧＡ阳性表达率明显低于非老年组（χ２＝４３９，Ｐ＜００５）．不同性别、Ｄｕｋｅｓ分期、有无淋巴结转移、分化程度高低及肿瘤不同发生部位ＣＧＡ表达率差异均无显著性（Ｐ＞００５，χ２检验），但在分化差组及直肠癌中其表达率有增高趋势．结论大肠癌内分泌样癌细胞的表达与性别、发生部位及临床病理无明显相关性，但老年组表达率明显低于非老年组，这可能是大肠癌的一个新的病理学特征．这一结果有助于老年大肠癌预后较好的解释，?

AIM To evaluate the clinical significance of endocrine like tumor cells in human colorectal carcinomas. METHODS The immunohistochemistry method (ABC) with polyclonal antibody of rabbit anti human chromogranin A (CGA) was used to determine the alteration of endocrine like tumor cells in surgically resected colorectal carcinoma tissues from patients (35 males and 27 females, aged from 19 to 78 years, with a mean age of 50 3 years). Of the 62 specimens, 44 were rectal carcinomas, 18 colonic carcinomas, 14 lymph node involvement and 48 non involvement. Dukes classification revealed 19 cases in stage A, 29 cases in stage B and 14 cases in stage C. All the specimens were fixed with 10% formalin, embedded with paraffin and sectioned at 5μm. In addition, the correlations among CGA postive tumor cells and the clinicopathologic data, the age and sex of the patients were also investigated. RESULTS CGA positive tumor cells were found in 35 5% of the patients with colorectal cancers, 20 0% (5 of 25) and 45 9% (17 of 37) in the aged and the nonaged ones respectively. The difference was significant (χ 2 test, P <0 05). No significant correlation was found among the CGA positive tumor cells and the sex, Dukes stages, tumor location, degree of histogical differentiation and the lymph node metastasis. CONCLUSION Low incidence of endocrine like tumor cells in the aged patients may be a new pathological feature for colorectal carcinomas which may contribute to explaining why the aged patients usually have a better prognosis. Its exact significance needs to be further characterized.