大肠癌旁移行粘膜的病理研究与临床意义

Pathological Study of Transitional Mucosa Adjacent to Colorectal Carcinoma and Its Clinical Significance

本文应用光镜、电镜,粘液组化、免疫组化及核DNA定量技术,对205例大肠癌及其癌旁TM、不典型增生进行了研究。结果表明,癌旁TM的分布与大肠癌Dukes分期及组织学类型关系密切。4种肿瘤相关抗原,在正常大肠粘膜全部呈阴性表达,而在癌旁TM,轻、中、重度不典型增生及癌的表达阳性率呈递增趋势。核DNA定量研究显示,由正常大肠粘膜、癌旁TM、不典型增生至不同分化程度的大肠癌,其核DNA均值呈递增现象。结果提示,癌旁TM核DNA的异常可能是病理改变的基础,其病理性质是介于正常大肠粘膜与不典型增生之间,并对癌旁TM的临床意义进行了讨论。

The specimens of 205 cases of colorectal carcinoma and its surrounding transitional mucosa (TM) and dysplastic tissue were studied with optical and electron microscopy, mucohistochemistry, immunohistochemistry, and microspectrophotometry. It was found that the distribution of TM was dependent on the Dukes' classification and histological types of colorectal carcinoma. The expression of the related antigens of monoclonal antibody MC3, MC5, CL-2, CL-4 in normal colorectal mucosa was negative, but the positive rate increased gradually in the order of TM, mild dysplastic tissue, moderate dysplastic tissue, severe dysplastic tissue, and cancer tissue. The amount of nuclear DNA of TM was intermediate between that of normal mucosa and that of dysplastic tissue, but much smaller than that of cancer. The findings suggest that the abnormal amount of DNA in TM surrounding colorectal carcinoma is responsible for the pathological changes in TM. The clinical significance of TM was also discussed.