早期胃癌细胞凋亡与增殖活性的研究

Study of Spontaneous Apoptosis and Celluler Proliferation Activity on Early Gastric Carcinoma

目的探讨早期胃癌细胞凋亡与增殖活性的临床病理意义。方法收集60例早期胃癌标本，采用切1：1末端标记法（IUNEL），电镜观察显示凋亡细胞，免疫组化En-Vosion法显示PCNA及P。蛋白表达．利用图像系统分析癌细胞DNA倍体。结果高分化型癌凋亡指数（ApoptosisIndex，AI）、AI／PI（PCNAIndex，PI）均高于低分化型癌（P〈0．05），而PI值、DNA〉王倍华值，则高分化型低于低分化型癌（P〈0．05）；癌限于粘膜层、粘膜下层时AI、AI／PI值逐层递减，而PI值、DNA〉王倍华值则逐层递增（P〈0．05），肿瘤直径〈5mm、5-10mm、〉10mm三组AI、AI／PI值随肿瘤增大而递减（P〈0．01），其pI值、DNA〉倍华值随肿瘤增大而递增（P〈0．05）、淋巴结阳性组PI值较阴性组高（P〈0．05），P53阴性组较P53阳性组AI值高（P〈0．05）。结论高分化、体积小的早期胃癌AI值较低，PI值增高；AI与PI呈负相关；PI值与淋巴结转移有关。显示癌瘤进展以细胞增殖为主而凋亡受抑。P53基因突变可显著降低癌细胞凋亡。

Objective To investigate the clinical pathological significance of the apoptosis and proliferation activity in human Early gastric carcinoma. Methods TUNEL （terminal uridine deoxynucleotide nick end labeling） and electron microscope were used to display apoptotic ceils. Immunehistoehemisty was used to detect the expression of PCNA and P53. DNA ploidy was determined by image analysis technigne. Results The＂ total 60 eases of colorectal cancer were observed. AI and AI/PI in well-differentiated cancer were significantly lower than those in poorly differentiated cancer （P〈0.05）. The deeper the invasion of the cancer, the lower the AI and AI/PI （P〈0.01） and the higher the PI and DNA〉5C （P〈0.05）. P53 negative staining cases had higher AI （P〈0.05）. Conclusion Well-differentiated, early or mid-term stage and small size fumours have higher AI and AI/PI. AI is negatively correlated with PI. PI is correlated with node metastasis. It indicated proliferation is increased and apoptosis inhibited with development of the cancer. P53 mutation can significantly decrease the apoptosis of colorectal cancer cells.