细胞凋亡与大肠腺瘤演化及癌变过程相关性的研究

目的探讨细胞凋亡在大肠腺瘤演化与癌变过程中的意义。方法利用原位末端标记(TUNEL)法检测46例不同阶段的不典型增生的大肠腺瘤、18例早期癌变的大肠腺瘤和58例进展期大肠癌标本中的细胞凋亡。结果在腺瘤-癌序列的细胞凋亡中,腺瘤伴轻、中、重度异型增生及大肠腺瘤早期癌变、大肠进展期腺癌的凋亡指数(AI)分别为(0.188±0.083)%,(0.181±0.136)%,(0.168±0.094)%,(0.074±0.047)%和(0.067±0.038)%,依次递减,有非常显著性统计学差异(P=0.000),大肠腺瘤大小之间、山田分型之间及不同的表面形态之间AI无统计学差异。结论在大肠腺瘤演化与癌变过程中细胞凋亡能力逐渐减弱,细胞凋亡紊乱可能是大肠肿瘤发生发展的重要因素之一。

A correlation study of apoptosis with the evolution and carcinogenesis of colorectal adenoma

Objective To investigate the significance of apoptosis in colorectal adenoma and its carcinogenesis. Methods Apoptosis of colorectal specimens,including 46 cases of different grade of atypical adenomatous hyperplasia,18 cases of early cancerous adenomas and 58 cases of advanced colorectal cancer,was detected by terminal dUTP nick end labeling（ TUNEL）technique. Results In adenoma - carcinoma se-quence apoptosis,the apoptotic index（AI）of adenoma with mild,moderate and severe dysplasia,early cancerous adenomas and advanced color-ectal cancer were（0. 188 ± 0. 083）% ,（0. 181 ± 0. 136）% ,（0. 168 ± 0. 094）% ,（0. 074 ± 0. 047）% and（0. 067 ± 0. 038）% respectively. There was a significant statistical difference（ P = 0. 000）. However,there was no significant statistical difference between different size of color-ectal adenoma,Yamada type and different surface morphology. Conclusion Gradually weakened ability of apoptosis and apoptosis disorder might be one of the most important factors in evolution and carcinogenesis of colorectal adenomas.