图像细胞分析与癌基因检测辅助诊断直肠癌

目的提高直肠癌术前活检的诊断率。方法对１７例术前活检未证实为直肠癌的患者的活检标本（实验组）和１５例正常肠粘膜活检标本（对照组）的石蜡包埋块进行常规病理检查、细胞图像分析（ＩＣＭ）、ｐ５３与ｒａｓ癌基因产物检测。结果实验组ＩＣＭ结果５３％为异倍体,癌基因检测结果ｐ５３与ｒａｓ基因表达阳性率分别为７１％、４７％。对照组的ＩＣＭ与癌基因检测结果均阴性。实验组中,常规病理检查１１例为不典型增生,５例为慢性炎症。常规病理检查为不典型增生的病例中经ＩＣＭ、癌基因检测８例为异倍体,ｐ５３与ｒａｓ基因表达阳性分别为１１和７例;慢性炎症病例中则既无异倍体,又无ｐ５３与ｒａｓ基因表达,二者之间,异倍体和两种基因表达阳性率差异均有显著意义（Ｐ＜００５）。ＩＣＭ与癌基因检测结果有较好的一致性。结论ＩＣＭ与癌基因检测,可以作为常规病理的补充,提高直肠良恶性病变的鉴别力。

The accessory diagnosis of rectal carcinoma by ICM and oncogene expressions

Objective To enhance the diagnostic accurate rate of preoperative biopsy on rectal carcinoma. Methods The paraffin embedded biopsy tissues of 17 cases of preoperatively unconfirmed rectal cacinoma and 15 cases of normal rectal mucosas (control group) were examined by routine pathology,image cytometry(ICM),and the expressions of protein products of oncogene p53 and ras. Results In the experimental group,53% specimens were classified as nondiploid by ICM,and the positive rates of p53 and ras expressions were 71% and 47% respectively. The positive rates were higher than those of routine pathology and the differences were significant. In the control group, the results of ICM and oncogene expressions were negative. In the experimental group,there were 11 cases of atipical hyperplasia and 5 cases of chronic Author inflammation only. Nondiploid,and positive expressions of p53 and ras were found in 8,11 and 7 cases of atypical hyperplasia respectively; however, they were all negative in chronic inflammation. The differences between atypical hyperplasia and chronic inflammation were significant. ICM was correlated well with expressions of p53 and ras oncogene. Conclusions The techniques of ICM and detecting the expressions of protein products of oncogene p53 and ras can be a supplementary tool for routine pathology to improve the diagnostic rate of rectal carcinoma.