喉粘膜上皮不典型增生定性诊断和早期喉癌诊断方法的探讨

Study on the methods of qualitative diagnosis of laryngeal displasia and early carcinoma

目的 :探讨喉粘膜上皮不典型增生定性诊断和早期喉癌诊断的方法。方法 :应用 p53基因PCR- SSCP分析、P53蛋白和 型胶原纤维蛋白免疫组化方法、流式细胞技术 (测细胞周期 )和核仁组成区嗜银蛋白 (Ag NORs)染色对 34例不典型增生上皮 (DS)、1 9例喉癌和 1 7例声带息肉的石蜡包埋组织进行研究。结果 :在 34例 DS中有 1 1例上述指标均为阳性 ,其中有 7例与病理诊断为癌相符合 ,有 4例病理诊断为良性 ;有 5例上述指标均为阴性 ,其中 2例病理诊断为癌 ,1例为良性 ,另外 2例无随访结果。结论 :只有将形态学指标和生物学指标联合应用 ,才能科学准确地对癌前病变进行定性诊断 。

? Objective:To study the methods of early qualitative diagnosis of laryngeal displasia and early carcinoma.Methods:We investigated displasia (34 cases),squamous cell carcimoa (19 cases) and vocal cord polyps (17 cases) of larynx which were embeded in paraffin by PCR-SSCP analysis of p53 gene,immunochemi stain of p53 protein and Ⅳ collagen,cytometer (determining fraction of cell cycle) and AgNOR stain.Results:Eleven of 34 cases of displasia were all positive in the indexes.Seven of 11 cases were also positive in pathology,but others were negative.Five of 34 cases of displasia were all negative in the indexes,2 of 5 cases were positive and 1 of 5 cases were negative,other two cases did not have following up results in pathology.Conclusion:The results suggest that it is the combination of the morphological indexes with biological indexe that is more scientific and more accurate in quatitative diagnosis of premalignant change.