直肠癌远端直肠系膜内DNA含量的检测及其临床意义

目的:探讨直肠系膜内DNA含量,为全直肠系膜切除术切除范围提供理论依据.方法:采用流式细胞术对37例直肠癌切除标本的癌组织、远端3 cm,5 cm处直肠系膜以及10例正常结肠系膜中的DNA含量、细胞增殖活性进行检测,分析比较各组间DNA指数(DI)、增殖指数(PI)及S期细胞百分比(SPF)等指标.结果:癌组织、癌远端3 cm,5 cm处直肠系膜中异倍体率及PI,SPF值均显著高于正常组织(P<0.05);远端直肠系膜中异倍体率与癌组织无显著差异;不同范围内的远端系膜中异倍体率、PI及SPF无显著差异.结论:直肠癌远端3 cm,5 cm处直肠系膜中存在着DNA含量及细胞增殖活性的异常改变,呈现出恶性肿瘤生物学特性,有必要行全直肠系膜切除术.

Content of DNA in distal mesorectum of rectal carcinoma and its clinical significance

Objective: To study the content of DNA in distal mesorect um of rectal carcinoma and to provide theory evidence for total mesorectal excis ion in the management of rectal cancer. Methods: In 37 cases o f rectal carcinoma, distal mesorectum (3 and 5cm below the tumor) and 10 cases of normal mesocolon, DNA index (DI), proliferation index (PI), and S-phase frac tion (SPF) were detected with flow cytometry. Results: The ane uplloidy rate, PI, and SPF in tumor and distal mesorectum (3 and 5cm below tumor ) were significantly higher than those in normal mesocolon(P<0.05). The an euploidy rate in distal mesorectum was also higher than that in tumor,but there was no significant difference. No difference of aneuploidy rate, PI, and SPF wer e found between distal mesorectum 3cm and 5cm below the tumor. Conclusi on: The abnormal changes of DNA content and cell proliferative activity which existed in the distal mesorectum (3cm and 5cm below the tumor) had biolog ical characteristics of malignant neoplasms. It is necessory to perform total me sorectal excision in the surgical management of rectal cancer.