大肠癌患者癌旁粘膜中生长抑素及其分泌细胞的变化和意义

Somatostatin and its secretory cells in tumor surrounding mucosa in colorectal cancer patients and its significance

作者对大肠癌患者癌旁粘膜中生长抑素（ＳＳ）水平进行了放射免疫测定（ＲＩＡ），并对ＳＳ分泌细胞（ＳＳ细胞）进行了免疫细胞化学观察。结果表明，癌近旁粘膜（ＣＡＭ，距肿瘤０ｃｍ～２ｃｍ）ＳＳ水平高于癌远旁粘膜（ＣＤＭ，距肿瘤约５ｃｍ）；无异型增生之ＣＡＭ中ＳＳ水平高于有不同程度异型增生者，相差均非常显著（Ｐ＜０．０１）。ＣＡＭ中，ＳＳ水平与异型增生程度间呈非常显著之负相关（Ｐ＜０．０１）。ＳＳ细胞的形态、位置近于正常；ＣＡＭ中ＳＳ细胞数和总阳性强度均高于ＣＤＭ粘膜，相差非常显著（Ｐ＜０．０１）。ＣＡＭ中ＳＳ水平与ＳＳ细胞数和总阳性强度间均呈非常显著之正相关（Ｐ＜０．０１）。作者认为，ＣＡＭ中ＳＳ上升的主要原因是粘膜中ＳＳ细胞数量增多并分泌大量的ＳＳ，这可能有助于延缓异型增生的加重和肿瘤的发生、发展，是机体发生于病灶局部的一种防御反应。

The somatostatin(SS) levels in tumor surrounding mucosae were determined by RIA, and the SS secretory cells in these tissues were observed by immunocytochemistry in colorectal cancer patients.The mean SS level was higher in cancer adjacent mucosa(CAM, 0￣2cm from the tumor) than in cancer distant mucosa(CDM, about 5cm from the tumor),and in CAM without atypical hyperplasia than in such mucosa with different grades of atypical hyperplasia( P <0 01). In CAMs, there was a very significant negative correlation between the SS level and cell dysplasia( P <0 01). The form and location of SS cells in all tumor surrounding mucosae were similar to the normal. Both the mean SS cell number and total positive degree were very significantly higher in CAM than CDM ( P <0 01). SS levels in CAMs were correlated positively with the SS cell numbers and the total positive degrees in CAM ( P <0 01).It is concluded that the elevation of SS level in CAM is mainly caused by the increase of SS cells, which secrete more SS. The change of SS in colorectal cancer surrounding mucosa may play an important role in inhibiting the development of CAM atypical hyperplasia or the tumor,and is a local defensive reaction in the body.