消化道类癌的免疫组化与DNA定量分析

Immunohistochemistry and DNA content of gastro intestinal carcinoid

目的 探讨消化道类癌临床病理与抗原表达、ＤＮＡ含量的关系。方法 ５２ 例类癌按照Ｇｏｕｌｄ 方法被分为３ 型：典型类癌２０ 例，非典型类癌２０ 例，低分化类癌１２ 例。３ 型同时进行１０ 种抗原标记免疫组化染色和流式细胞仪细胞核ＤＮＡ 定量分析。结果 血管活性肽（ＶＩＰ） 、降钙素（ＣＴ） 在典型类癌组中的分布低于其他两型，差异有显著性（ Ｐ＜ ００５） ；癌胚抗原（ＣＥＡ） 在典型类癌中的分布低于其他两型，差异有非常显著性（Ｐ＜ ０ ．００１）。三者在进展期癌组表达显著高于早期癌组（ Ｐ＜ ０．０５） ，ＶＩＰ在淋巴结转移组表达显著高于非转移组。ＤＮＡ 倍体在各组织类型中的分布差异有显著性（ Ｐ＜０ ．０１） ，在早期癌与进展期癌组、淋巴结转移与非转移组的分布差异均有显著性（ Ｐ＜ ０ ．０５） 。ＶＩＰ、ＣＥＡ阳性标本大多数为异倍体（１６／２０，９／１１） ，这些异倍体均表现为非整倍体。结论 抗原表达、ＤＮＡ定量分析以及两者关系有助于类癌的分化、生物学行为及对预后的估计。

Objective To study the relationship between clinical pathology and antigen expression and DNA content of gastrointestinal carcinoid tumors. Methods Fifty two cases of paraffin embedded gastrointestinal carcinoid specimens were collected. According to Gould′s criteria, there were 20 cases of typical carcinoid, 20 cases of atypical carcinoid and 12 cases of undifferentiated carcinoid. Ten different kinds of antigen were examined by immunohistochemical staining and DNA contents by flow cytometry. Results Calcitonin (CT), carcino embryonic antigen (CEA) and vasoactive intestinal peptide (VIP) expression was significantly reduced in typical carcionoid compared to that in the other two types of carcionoid. Their expression was more marked in progression than in early stage of the disease. VIP expression was significantly higher in patients with than without lymph node metastases. Cellular DNA analysis showed significant difference between the typical and the other two types of carcinoid. Tumors with expression of VIP and CEA were mostly aneuploid. Conclusion To study expression of relevant antigens in gastrointestinal carcinoid in relation to histological type and cellular DNA content helps determine its biologic behavior and prognosis