大肠癌细胞DNA含量与形态学定量分析

Quantitative Analysis of DNA Content and Morphology of Colorectal Carcinoma

目的探讨大肠癌的生物学行为及其临床诊治价值。 方法应用流式细胞仪 (flowcytometry ,FCM)和扫描显微分光光度计 (microspectrophotometry ,MSP)对 88例大肠癌和腺瘤以及 83例正常结肠粘膜的细胞核进行DNA含量测定、倍体分析和细胞周期研究 ,所获数据与临床病理指标和血清癌胚抗原 (carcinoembryonicantigen ,CEA)作比较。 结果正常结肠粘膜的细胞核DNA含量均为二倍体 ,DNA指数 (DI)为 1.0 0± 0 .10 ,MSP直方图为I型。大肠腺瘤的细胞核DNA含量明显低于大肠癌组 (P <0 .0 1) ,而与正常结肠粘膜相比无显著差异 (P >0 .0 5 ) ,其细胞核面积与大肠癌组无显著差异 (P >0 .0 5 )。 83例大肠癌细胞中异倍体检出率为 6 8.6 8% ,DI >1.10或 <0 .90 ,癌细胞核DNA含量与细胞核面积显著相关 (r =0 .71,P <0 .0 1)。随着Dukes分期的升高 ,异倍体检出率上升 ,二者呈正相关。细胞周期分析表明二倍体癌DNA合成期分数 (SPF)介于正常结肠粘膜和异倍体癌之间。异倍体癌病人的术前CEA水平显著高于二倍体癌 (P <0 .0 5 )。FCM的DI值与MSP的模态均值 (MV)有很好的相关性 (r=0 .73,P <0 .0 1) ,异倍体癌符合率达 95 % ,然而二倍体癌符合率仅 5 0 %。 结论DNA含量的检测有利于大肠癌的早期发现 ;倍体分析与CEA在评估大肠癌?

Objective To understand the biological behavior of colorectal cancer and its clinical value. Methods Using flow cytometry and scanning microspectrophotometry, we determined the cellular DNA content, ploidy and cell cycle fraction in 88 patients with colorectal carcinoma and precance rous lesions, and in 83 cases with normal colonic nucosa. Also we compared the results with clinical pathological parameters and CEA levels. Results Normal colonic mucosa had the same DNA contents as normal diploid cells (2C), with a DNA index (DI) in rang of 1.00±0.10.MSP histogram was defined as type I. The cellular DNA content of precancerous lesions (adenoma, polyp) was lower than that of cancer ( P <0 01); While their cellular nuclear areas were not much different from those of cancers ( P >0.05). The aneuploidy of DNA was 68.68% in 83 cases of colorectal cancer, with DI>1.10 & <0.90. Their cellular nuclear DNA contents correlated with nuclear areas (r=0.71,P<0.01). As the clinicopathological classification of Dukes ascended, the incidence of aneuploidy became higher. Cell cycle analysis indicated that the DNA synthesis fraction (SPF) of diploidy carcinomas was between normal colonic mucosa and aneuploidy carcinomas. The CEA values in aneuploid tumors ( 12.85ng/ml ) were much higher than those of diploid tumors (7.82ng/ml) before operation(P<0.05). The DNA index by FCM and modal values by MSP had strong correlation (r=0.73, P<0.01), being 95% in aneuploidy tumor and 50% in diploidy tumors. Conclusion The detection of DNA content is beneficial to early discovery of colorectal cancer. The analysis of DNA ploid is in accordance with CEA in predicting the prognosis of colorectal cancer. FCM and MSP in combination can provide an approach to early diagnosis, prediction of prognosis and selection of appropriate therapeutic methods for colorectal cancer.