切缘硫酸性肠化与胃癌术后复发关系的研究

Study of Relationship Between the sulfomucin type of intes-tinal meta-plasia(SIM) at the resected margins of the stomach and local recurrence after operation for gastric carcinoma

应用组织化学方法对27例胃癌术后复发病例(复发组)的原切除标本切缘的硫酸性肠化进行检测,并与30例同期未复发病例进行比较(对照组)。结果复发组发现硫酸性肠化18例(66.7％),显著高于对照组(4例,13.3％)。然后应用流式细胞术对18例硫酸性肠化和17例非硫酸性肠化粘膜上皮的DNA倍体类型和增殖指数进行了定量研究。结果发现,复发组的DNA异倍体类型和增殖指数均显著高于对照组。上述研究结果表明,硫酸性肠化上皮有显著增生活性和潜在恶变的特性,可能与术后复发有关;建议将手术标本切缘硫酸性肠化阳性患者视为胃癌术后复发的高危人群。

The sulfomucin type of intestinal metaplasia(SIM) at the resected margins of gastric cancer specimens was investigated histochemically in 27 patients with local recurrence (recurrence group) and 30 without (control group).The results indicated that the number of resected margins with SIM in recurrence group(18/ 27)were significantely higher than those in control group(4/30)(P<0.005). 18 cases of the resected margins with SIM and 17 cases without SIM were analyzed by flow cytometry(FCM) to measure DNA ploidy patterns and proliferative index(PI). The precentage of DNA aneuploidy and PI in SIM-positive margins were significantely higher than those in SIM-negative ones. These suggested that cells with SIM-positive margin had proliferative capacity and a latency to become malignant which were associated with local recurrence after operation, and this kinds of patients shoude be considered as high risk population of local recurrence.