直肠癌安全分子切缘的初步研究

Preliminary study on safe molecular margin of rectal carcinoma

目的:从组织病理学和分子病理学水平探讨直肠癌安全的分子切缘。方法:收集直肠癌根治术后标本30例,在肠管自然张力下距肿瘤近切缘1～5 cm(P1～P5)和远切缘1～5 cm(D1～D5)每隔1 cm取标本,应用免疫组织化学和原位杂交2种方法分别检测标本Twist、CEA和ki67的表达,比较与肿瘤不同距离组织肿瘤标志物表达的差异。结果:Twist、CEA和ki67在癌旁移行黏膜的表达随与肿瘤距离的增加均呈减弱趋势。距近切缘>4 cm时3个肿瘤标志物的表达均为阴性;距远切缘>2 cm时3个肿瘤标志物的表达均为阴性。结论:距近切缘5 cm处、距远切缘3 cm处可确定为直肠癌根治术的最小安全切缘。

Objective： To investigate safe molecular margin of rectal carcinoma histopathologi- cally and molecular pathologically. Methods： 30 tissue samples after radical resection of rectal car- cinoma were collected. Samples were collected at a distance of 5cm from proximal margin and distal margin of tumor at natural tension of intestinal canal. Immunohistochemistry and hybridization in situ technique were used to detect the expression of Twist, CEA and ki67, and compared the variance of the expression of the tumor markers at different distance from tumor. Result： The expression of the three tumor markers showed a decline trend in transitional mucosae adjacent to carcinoma with the distance from tumor increases. The expression of three tumor markers were negative when the distance from proximal margin is longer than 4 cm, the expression of three tumor markers were negative when the distance from distal margin is longer than 2 cm. Conclusion： 5 cm proximal and 3 cm distal to the tumor can be decided the safe proximal and distal margin of the radical operation of rectal carcinoma.