家族遗传性结直肠息肉病恶变过程中的DNA变化

Change of DNA parameters in the process of canceration and evolution of familial polyposis of the colon and rectum

目的研究家族遗传性结直肠息肉病(FPC)恶性演变过程。方法采用真彩色医学图象分析系统对29例FPC、60例结直肠癌和56例腺瘤性息肉标本的DNA含量和倍体分布进行对比研究。结果恶变FPC组织DNA含量(DI)明显高于DucksA、B期和高、中分化腺癌,差异有显著性意义(P<0.05),而与DucksC、D期和低分化腺癌比较则差异无显著性意义(P>0.05)。从没有恶变的FPC息肉到恶变的FPC组中未恶变息肉再至恶变的FPC组织,DNA异倍体(≥5倍体)和DI值逐渐增加,各组间比较差异有显著性意义;在各息肉组中,恶变的FPC组息肉和重度异型性腺瘤性息肉,异倍体和DI值都高于轻中度异型性腺瘤性息肉和未恶变的FPC息肉(P<0.01),而且同DucksA期和高分化腺癌异倍体和DNA含量相近(P>0.05)。结论FPC恶变过程是逐渐发生的,一旦恶变,恶性程度较高,易发生转移,预后较差;而另一些未恶变的息肉已属于高危癌前病变,手术中应一并切除。

Objective To study the canceration and evolution of familial polyposis of colon(FPC). Methods DNA parameters of 29 samples from FPC,60 from large intestinal carcinoma and 56 from polyposis were detected.Results DNA index(DI)of FPC canceration group was significantly higher than that of Ducks A,B stage and that of well differentiated carcinoma (P< 0 05),but as compared with that of Ducks C,D and poor differentiated carcinoma,no significant differences were found(P >0 05).From non canceration′s FPC polyp to canceration′s FPC group,DNA multiploidy(≥5 ploidy)and DI increased gradually,and significant difference existed between the two groups. Multiploidy and DI of canceration′s FPC polyp were higher than that of non canceration′s FPC polyp(P< 0 01),and similar to that of Ducks A stage and that of well differentiated carcinoma(P >0 05). Conclusions The process of FPC canceration is gradual.Once canceration occurs FPC is easy to become cancer with great possibility and to metastasize.Non canceration polyposis is also a high risk factor,which should be cut off during the operation.