晚期喉癌切缘组织流式细胞仪参数及PCNA表达的研究

Changes of flow cytometry parameters and PCNA expression in the adjacent tissues of advanced laryngeal carcinoma

目的:探索细胞增殖活性在晚期喉癌组织周围的变化规律,确定合理的晚期喉癌安全切缘。方法:用流式细胞仪及免疫组化检测晚期喉癌患者喉癌组织(A组)、癌旁0.5cm(B组)、1.0cm(C组)、2.0cm(D组)处组织细胞的DNA异质性、DNA含量、增殖指数及PCNA表达。结果:异倍体率:喉癌组织、0.5cm、1.0cm、2.0cm处组织分别为70.4％、14.8％、0、0。A与B组和B与C组间均有显著性差异;DI值:A、B、C对组分别为1.61±0.52、1.08±0.38、1.03±0.31、1.02±0.13,A与B组和B与C组间均有显著性差异;PI值(％)分别为26.06±6.73、12.27±3.78、11.37±2.86、11.01±1.92从组与B组间有显著性差异,但B组与C组、C组与D组间均无显著性差异;SPF值(％)分别为22.38±6.15、11.17±3.92、10.81±3.37、10.55±3.06,免疫组化PCNA指数(％)分别为67.8±12.25、12.76±4.36、11.33±3.25、10.89±3.13。结论:从晚期喉癌组织向周围正常组织移动过程中,肿瘤细胞的增殖指标、DNA含量逐渐趋向正常,于癌周0.5cm处接近正常,于1.0cm处基本正常;晚期喉癌旁0.5cm可作为手术的基本安全切缘,1.0cm可作为理想安全切缘。

Objective: To study how cellular proliferative vigor and PCNA expression change between advanced laryngeal carcinoma (LC) and the adjacent tissues of cancer, and to determine the safe surgical margin of larynx with advanced LC. Methods: The specimens acquired from LC tissue and the tissues at the sites of 0. 5cm, 1.0cm, 2.0cm away from LC periphery were classified as four groups A,B,C,D, and were detected by approaches of flow cytometry and immunohisto-chemistry. Results: Heteroploid rates of tissues in A,B,C,D groups were 70. 4% , 14. 8% ,0,0 respectively. The difference between A and B groups, B and C groups were significant. DI in groups A,B,C, and D were 1. 61 ±0. 52, 1. 08±0. 38,1. 03±0. 31,1. 02±0. 13 respectively, the differences between A and B, B and C were significant, and the difference between C and D is not significant. PI (%) were 26. 06±6. 73,12. 27±3. 78,11. 37±2. 86,11. 01±1. 92 respectively, the difference between A and B was significant and differences between B and C, C and D were not significant. SPF (%) were 22. 38 ±6. 15,11. 17±3. 92,10. 81±3. 37,10. 55±3. 06 respectively. The results of statistical analysis were similar to PI. PCNA index (%) was 67. 8±12. 25, 12. 76±4. 36,11. 33±3.25,10. 89±3. 13 respectively. The results of statistical analysis were similar to DI. Conclusions: The parameters including heteroploid, DNA content, proliferative index, PCNA, etc, turned gradually into normal level from LC tissues to the normal tissue. These results are near to normal level in the tissues at the site of 0.5cm away from LC, and are normal at 1. 0cm away from LC. 0. 5cm away from LC periphery may be determined as basic safe surgical margin, and 1.0cm may be determined satisfactory safe surgical margin.