直肠癌Dixon术后直肠下端切缘p53突变基因分析

Analysis of p53 mutation on the low margin of rectal Dixon operative in patients

目的:探讨Dixon手术直肠下端切缘p53基因突变情况及其与肿瘤预后的关系.方法:分析1990年以来Dixon直肠癌根治手术病人术后三年以内死亡和生存五年以上两组病例的临床情况,采用免疫组化的方法,检测两组不同生存期病人的直肠癌下段切缘p53基因突变率.结果:两组病例在肿瘤位于直肠的位置和病理的淋巴转移率有显著差异.在两组直肠下端病理均未见癌细胞的情况下,三年组p53突变检测分析3/19阳性,而五年组为2/24阳性.无显著性差异.结论:病理检查肿瘤切缘为正常细胞的部位,确实存在分子水平的、肿瘤相关异常基因细胞,表现为散在性点状、巢状分布.这应非一种孤立的、偶然的表现.

Objective:To study the relationship between the cancer prognosis and p53 gene mutations on the low margins of rectal cancer with Dixon operation. Methods:The rectal cancer patients with Dixon operation were divided into two groups according to survival rates within 3 year or more than 5 years, analysising clinical, operative and pathological situation of two groups. p53 mu- tation on the cells at the low margin of rectal cancer of the two groups by immunohistochemical assay. Results: There were significant-ly difference in tumor situations and metastasis of lymphocyte between two groups. Even no cancer cells on the low margin of rectal cancer in all patients according pathology, positive results of p53 mutation were 3/19 in 3 year groups, 2/24 in 5 year group respec-tively. Conclusions: Although there are normal cells on the low margins of rectal cancer by pathological studies, abnormal genes relat-ed with cancer, do existe in the cells at the low margins of rectal cancers on molecular level. The cells of p53 mutation are presented point, cluster or scatter distributions, but not episodic. It may has some clinical meanings, needed further study.