流式细胞术检查及病理学观察对喉癌5mm切缘安全性的评价

FCM detection and pathology observation of 5mm cutting-edge of laryngocarcinoma

目的 :分析喉癌、切缘及正常组织的DNA倍体特征及细胞周期特征 ,结合病理检查探讨 5mm切缘安全性。方法 :采用流式细胞术 (FCM )检测 2 0例喉癌患者冻存的喉癌标本及其 5mm切缘的DNA含量 ,并与正常声门组织 (5例 )作对照 ,进行统计学分析 ;同时对部分喉癌标本及切缘组织 (0 .5cm)进行病理学观察 ,并与FCM测值进行比较。结果 :喉癌标本、切缘及正常组织的异倍体率分别为 6 0 % (12 / 2 0 )、15 % (3/ 2 0 )及 0。喉癌、切缘组织S期百分比分别为 2 0 .33± 6 .12及 12 .35± 3.81,DI值分别为 1.78± 0 .82及 1.0 7± 0 .0 4 ,PI值为 2 9.0 9±6 .8及 11.75± 3.75 ,差异均存在显著性意义 (P <0 .0 5 )。光镜下 3例 5mm切缘可见癌累积 ,表现为癌细胞的粘膜下浸润和以原位癌形式延伸 ,与FCM检查异倍体的出现表现出相对一致性。结论 :5mm切缘对早期喉癌是安全的 ,但当肿瘤侵犯到声门旁隙时 ,肿瘤易浸润粘膜下 ,5mm切缘是不安全的。

Objective:To explore the safety of 5mm cutting edges with the analysis of DNA contend and cell cycle and the pathology observation. Method:Twenty specimens of laryngocarcinoma and its cutting edges were analyzed by flow cytometry, contrasting to 5 samples of normal larynx tissue,and their light microscopy and electra microscopy were discussed. Result:The DNA aneuploidy(AN) rate in the laryngocarcinoma, its cutting edges and the normal tissue is respectively 60% (12/20), 15%(3/20) and 0. The rate of S phrase of the laryngocarcinoma and its cutting edges is respectively 20.33 ± 6.0 and 12.35 ± 3.81 , so the DI 1.78 ± 0.82 and 1.07 ± 0.04 ,PI 29.09 ± 6.8 and 11.75 ± 3.75 , there are significant differences (P< 0.05 ). The light microscopy showed 5 mm cutting edges were infiltrated by carcinoma in the form of submucosa or extention of carcinoma in situ and the results was, to some extension, consistent with the findings of FCM. Conclusion:The safety of 5mm cutting edge varies depending on whether invading paraglottic space.