IMMUNOHISTOCHEMICAL STUDY OF CARCINOEMBRYONIC ANTIGEN IN THE TRANSITIONAL MUCOSA ADJACENT TO COLORECTAL CANCER

A combined histopathological, mucin histochemi-cal and immunohistochemical study of the transitional mucosa (TM) adjacent to colorectal cancer is presented. Twenty-six resected specimens were studied by hematoxylin and eosin (HE) and high iron diamine-alcian blue (HID-AB). Carcinoem-bryonic antigen (CEA) was demonstrated by peroxi-dase antiperoxidass (PAP) technique. The appearance of the TM is usually thicker, longer and dilated crypts with increased immature and intermediate cells. Variable amount of sialomucins and decrease sulphomucins content as well as increased CEA content are found in the TM. These changes are not seen in non-transitional zone and normal colorectal mucosa. It is suggested that the mucin changes and expression of CEA in the TM may indicate an early primary premalignant changes and may be one of the reasons for the TM affecting the prognosis of patients with large bowel cancer after radical resection.

直肠癌旁移行黏膜P21、P53蛋白表达及其对保肛术的影响

目的研究直肠癌癌旁黏膜p21、p53蛋白的表达,探讨对直肠癌切缘距离的临床意义。方法应用免疫组化方法检测34例直肠癌癌旁移性黏膜中p21、p53蛋白表达。结果①直肠癌远端扩散有9例,占29.4%,远端扩散距离均在2cm以内;②34例直肠癌标本其癌组织远端均表现为癌旁黏膜,其癌旁黏膜的距离均未超过4cm;③P53蛋白在癌组织中表达阳性为20例,阳性率为58.6%;在癌旁表达为10例,阳性率为29.3%。同时资料表明两者之间无显著性差异;④P21蛋白在癌组织中表达阳性为21例,阳性率为61.5%;在癌旁组织表达为9例,阳性率为26.4%。同时资料表明两者之间无显著性差异。结论直肠癌远端肠管移性黏膜2～4cm处于癌前病变状态,建议远端切除距离应更长些。

癌旁移行粘膜P53蛋白表达对判断直肠癌远端切缘的临床意义

目的检测癌旁粘膜p53蛋白的表达,探讨远端肠壁内浸润的分子长度及其对临床指导意义。方法应用免疫组化方法检测34例直肠癌癌旁移性黏膜中p53蛋白表达。结果(1)直肠癌远端扩散有9例,占29.4%,远端扩散距离均在2 cm以内。(2)34例直肠癌标本其癌组织远端均表现为癌旁黏膜.其癌旁黏膜的距离均未超过4 cm。(3)P53蛋白在癌组织中表达阳性为20例,阳性率为58.6%;在癌旁表达为10例,阳性率为29.3%。结论直肠癌远端肠管移性黏膜2-4厘米处于癌前病变状态,用免疫组化染色较常规HE测量直肠癌远端浸润长度更准确,对指导临床更有意义。