大肠癌组织中PCNA表达和细胞凋亡检测的临床意义

目的：探讨大肠癌组织中细胞凋亡和增殖细胞核抗原（PCNA）表达的临床意义。方法：应用免疫组化S－P法及TUNEL法对10例正常大肠黏膜和62例大肠癌组织中细胞增殖指数（PI）及凋亡指数（AI）进行检测，分析其与临床病理因素的关系。结果：在正常大肠黏膜和大肠癌组织中，PI逐渐增加，AI逐渐下降，两者比较有非常显著性差异（P＜0．01），随着大肠癌Dukes分期升高，PI逐渐增加，AI逐渐下降；与癌组织分化程度和淋巴结转移有关（P＜0．01），对这2种指标进行综合分析显示，PI增高而AI降低组，较其它异常结合模式组更易发生淋巴结转移。结论：细胞增殖与凋亡平衡失调的程度与大肠癌恶性程度密切相关，PI增高同时有AI降低者更易发生淋巴结转移，两者联合检测对大肠癌的临床分析及预后评价有重要意义。

Expression of PCNA and Apoptosis in Human Colorectal Carcinoma and Their Clinical Significance

Objective To study the apoptosis and the expression of proliferating cell nuclear antigen(PCNA) in colorectal carcinoma and their clinical significance.Methods Apoptotic index(AI) and proliferative index(PI)were determined in paraffin-embeded tissues from 62 cases of colorectal carcinoma and 10 cases of normal colon mucosa with immunohistochemistry S-P method and TUNEL technique.Results PI in colorectal carcinoma was increased and AI was declined compared with in normal colon mucosa.The difference between two groups was significant(P<0.01).With Dukes stage advancing,PI enhanced,meanwhile AI declined.AI and PI were also correlated with differentiation and lymph node metastasis.Combined analysis of apoptosis and PCNA expression indicated that high PI with low AI had a more possibility to result in lymph node metastasis than other abnormal patterns in colorectal carcinoma(P<0.01).Conclusion The extent of imbalance between colorectal carcinoma cell proliferation and apoptosis is correlated to degree of malignancy.The patient with high PI and low AI may have more possiblity to result in metastasis of colorectal carcinoma.It will be helpful for predicting the long-term prognosis and evaluating clinical stages of colorectal carcinoma with both PCNA and apoptosis examination.