50例癌症原位末端标记凋亡形态学研究

Morphologic study on apoptosis by insitu end labeling of 50 cancer cases

目的 探讨恶性肿瘤中癌症凋亡的形态学及其与坏死的区别。方法 取 50例常见癌症组织作HE及原位末端标记(ISEL) ,按Gavrieli法进行 ,并作阳性和阴性对照。凋亡的标准是HE见核浓缩、碎裂而ISEL阳性 ;坏死的标准是红染无结构 ,ISEL阴性或弱阳性。将凋亡按形态分为早期、中期和后期 (凋亡性坏死 ) ;又按病灶大小分为单个细胞、小片性和大片性。少数病例作了M30 Cytodeath免疫组化。结果 ISEL与HE结果基本吻合。 50例所检出的凋亡病灶数目明显多于坏死者 (P <0 .0 1)。不同大小的凋亡病灶之间和各期凋亡之间的发生率均无显著差异 (P >0 .0 5)。对凋亡形态作了描述。 3例卵巢癌M3 0 Cytodeath单抗检出凋亡癌细胞胞浆阳性。个别凋亡性坏死灶形态特殊 ,其HE与坏死无异 ,但ISEL显出阳性的核。结论 大多数癌组织的凋亡与坏死HE形态明显不同 ,且凋亡ISEL阳性而坏死阴性 ;故二者可以区别。凋亡性坏死的形态及机制虽较复杂 ,但ISEL阳性 ,其本质应属于凋亡而非坏死。

ObjectiveTo study the morphology of apopt osis of malignant tumors and its differences from necrosis.MethodsCancer tissues from 50 cases of various common cancers were measured by HE and in situ end labeling(ISEL) according to Gavrieli's metho d;positive and negative controls were made.3 cases were measured by M 30 -C ytodeath monoclone antibody immunohistochemistry.Apoptosis or necrosis lesions w ere divided into single cell,small piece,and massive according to the size.The a poptosis lesions(ISEL+) were divided into early,middle and late stage(the latter equal to apoptotic necrosis) according to the morphology.The criteria of non-a poptotic necrosis(necrosis) were ISEL(-),and no piknosis or karyorrhexis in HE. R esultsThe number of apoptosis lesion was signifieantly more than necro sis( P <0.01),while there were no evident differences among different sizes and among different stages of the apoptosis lesions( P <0.05).The apoptosis morphology was described.3 Cases of ovarian carcinoma were M 30 -Cytodeath positive i n the cytoplasm of apoptotic cance cells.The minor apoptotic necrosis lesions wa s special.There was no difference between apoptotic necrosis and necrosis in HE, while ISEL revealed positive nuclei.ConclusionThe majority of cancer tissues the HE morphology betwe en apoptosis and necrosis was evidently different,and ISEL was positive in apopt osis,negative in necrosis.So,both lesions were distinguishable.Although the mech anism of apoptotic necrosis was complicated,its ISEL was positive,so its nature should belong to apoptosis,not necrosis.In cancer tissues,the number of apoptosi s lesions was much nore than that of necrosis.