摘要
目的探讨内分泌细胞(EC)在大肠癌及癌旁的表达意义.方法应用LSAB免疫组化法,对117例大肠癌及85例癌旁粘膜中嗜铬蛋白A(CGA)及几种激素进行检测,13例大肠癌行电镜观察.结果EC阳性大肠癌46例(393%),检测到一种以上激素692%(27/39),癌旁粘膜EC数高于正常肠粘膜.电镜观察8例有含内分泌颗粒的癌性EC.在中低分化癌中EC(++)的表达(255%)高于高分化癌(69%)(χ2=754,P<005),含有EC的大肠癌淋巴结转移的发生率(680%)高于不含EC者(437%)(χ2=623,P<005),且预后不良;5HT,βHCG,Glu,Gas阳性癌分化及预后较差(P>005).结论含EC的大肠癌具有更恶性的生物学行为,可能与EC中某些激素,通过旁分泌等途径促进肿瘤的生长转移有关,癌旁EC增生与周围肿瘤生长有关.
AIM To study the expression and clinical significance of endocrine cells (EC) in colorectal cancer (CC) and its adjacent mucosa (MAC). METHODS Chromograin A (CGA) and five kinds (5 HT, β HCG,Gas,Glu and SS) of hormones in 117 CC cases and 85 MAC cases were detected by LSAB immunohistochemistry. Thirteen cases of CC were observed under electron microscope. RESULTS CGA positive cells (EC) were found in 46 CC cases (39 3%). In 69 2%(27/39) more than one hormone were expressed . The number of EC in MAC was higher than that in normal mucosa. Cancer cells containing endocrine granules were found in 8 CC cases under electron microscopy. The incidence of EC (++) in CC with moderate and poor differentiation (25 5%) was higher than in CC with high differentiation(6.9%) (χ 2=7 54, P <0 05). The lymph node metastasis rate in the EC positive CC (68.0%) was higher than EC negative CC (43 7%) (χ 2=6 23, P <0 05). CC containing EC gave a shorter survival. 5 HT, β HCG,Glu and Gas occurred more often in tumors with poor differentiation, and had poorer prognosis ( P >0 05). CONCLUSION EC positive CC has worse biologic behaviour. Some hormones secreted by EC could partly account for the growth and metastasis of CC by paracrine. EC hyperplasia of MAC is related with growth of CC.
关键词
大肠癌
癌旁内分泌细胞
免疫组化
colorectal neoplasms
colonic neoplasms
rectal neoplasms
endocrine cells
peptides
biogenic amines
immunohistochemistry