大肠癌及癌旁粘膜p21~(ras)表达及意义

应用免疫组织化学方法对 12 8例人大肠癌及 32例不同距离癌旁粘膜进行研究。探讨 p2 1ras检测的临床病理学意义。结果 ,正常大肠粘膜、大肠癌、近癌旁粘膜、癌旁 1cm、2 cm、3cm及 5 cm粘膜 p2 1ras阳性率分别为 5 .0 % (1/ 2 0 )、5 2 .3% (6 7/ 12 8)、2 4.7% (18/ 73)、18.8% (6 / 32 )、15 .6 (5 / 32 )、9.4% (3/ 32 )及 9.4% (3/ 32 )。癌旁 3cm、5 cm粘膜的p2 1ras阳性率、阳性强度及分布均与正常粘膜相似 ,但癌旁 1cm、2 cm粘膜 p2 1ras阳性率较高且其中 5 0 %表达强度为(+ + )、(+ + + ) ,提示有 p2 1ras过表达现象。 p2 1ras表达与大肠癌临床病理因素无关。结论 :大肠癌中存在 p2 1ras过表达 ,且在癌旁 1cm、2 cm以内粘膜也存在 p2 1ras过表达可能 ,因此建议 ,在临床行大肠癌切除时 ,安全切缘至少在 3cm以上。

Expression of p21~(ras)in Colorectal Carcinoma and Paracancerous Mucosa and Its Significance

p21\ \{ras\} proteins were detected by immunohistochemistry in 128 cases of human colorectal carcinoma and 32 cases of paracancerous mucosa. The positive rate of p21\ \{ras\} expression in normal mucosa , carcinoma, 1cm , 2cm , 3cm and 5cm paracancerous mucosa was 5.0%(1/20), 52.3%(67/128), 18.8%(6/32),15.6%(5/32),9.4%(3/32) and 9.4%(3/32) respectively. The positive rate , intensity and distribution of p21\ \{ras\} expression in 3cm and 5cm paracancerous mucosae were similar to that in normal mucosa, while 50% of paracancerous mucosae cases within the range of 2cm presented and over expression of p21\ \{ras\}, which was similar to carcinoma cases . The expression of p21\ \{ras\} in carcinoma, however, was found to have no relation to the clinicopathological features. It is concluded that the over expression of p21\ \{ras\} exists in colorectal carcinoma and its paracancerous mucosa within 2cm distance . It is therefore suggested that the incisal margin should be at least 3cm beyond carcinoma so as to prevent recurrence and metastasis after surgery.