结直肠腺瘤-癌序列的生长动力学——增殖细胞核抗原的免疫组化研究

Growth kinetics of colorectal adenoma-carcinoma sequence —An immunohistochemical study of proliferating cell nuclear antigen expression

目的 探讨增殖细胞核抗原 (PCNA)在结直肠腺瘤 -癌序列中的表达变化。方法 采用免疫组化S -P法分别检测 13例家族性腺瘤息肉病 (FAP)的扁平粘膜和腺瘤、18例结肠散发性腺瘤、18例散发性结肠癌的PCNA表达。结果 PCNA在FAP患者扁平粘膜、腺瘤的标记指数 (LI)分别为 39.74%± 10 .0 8%和 6 5 .73%± 16 .41% ,前者与正常对照比较差异无显著性 ,后者明显高于正常对照 (P <0 .0 5 )。散发性腺瘤及结肠癌的LI分别为6 5 .95 %± 12 .94%和 84.5 3%± 10 .39% ,均明显高于正常对照 (P <0 .0 1) ;且结肠癌高于腺瘤 (P <0 .0 5 )。结论 结直肠癌前病变中存在活跃的细胞增殖 ,在由正常粘膜向癌的转化过程中细胞增殖逐渐增加和活跃 。

Objective To investigate the expression of proliferating cell nuclear antigen (PCNA) in colorectal adenoma-carcinoma sequence.?Methods Expression of PCNA was detected by immunohistochemical method (S-P method) in flat mucosa and adenomas from 13 cases of familial adenomatous polyposis (FAP) and in the tumor tissues from 18 cases of sporadic adenoma and 18 cases of sporadic colorectal carcinoma.?Results The PCNA labeling indexes (LI) in flat mucosa and adenoma of FAP were 39.74%±10.08% and 65.73±16.41%, respectively. The former was not higher compared with the healthy control. The latter was significantly higher than the control ( P <0.05). Sporadic adenomas and carcinomas had significantly higher PCNA LI than control specimens( P <0.05).The PCNA LI was significantly higher in carcinomas than in adenomas too.?Conclusion There is abnormal cell proliferation in colorectal precancerous lesion. An abnormal regulation of cell proliferation may play an important role in the adenoma-carcinoma sequence.