大肠癌根治术后吻合口复发与残留移行粘膜的关系

用HID—AB染色法(High iron diamine-Aleian blue staining)对大肠癌根治术后肠管切缘粘膜进行研究,结果表明:大肠癌根治术后28例吻合口复发病人,其肠管切缘粘膜18例呈唾液酸粘蛋白反应,6例呈混合粘蛋白反应,4例呈硫酸粘蛋白反应。根治术后32例吻合口无复发病人,其肠管切缘4例呈唾液酸粘蛋白反应,9例呈混合粘蛋白反应,19例呈硫酸粘蛋白反应。经统计学处理两者差别非常显著。(P<0.01),本文研究提示:大肠癌根治术中肠管切缘残留移行粘膜是引起大肠癌复发的又一重要因素。对移行粘膜的进一步认识和研究可能更新大肠癌根治术的概念,改变大肠癌根治术肠管切除的范围标准。

A CORRELATION BETWEEN THE ANASTOMOTIC RECURRENCE AFTER CURATIVE SURGERY OF LARGE BOWEL CARCINOMA AND THE RESIDUAL TRANSITIONAL MUCOSA

60 Specimens of large bowel mucosa after curative resection for carcinoma was studied, using high iron diamine alcian blue (HID-AB) staining. We have found that among 28 specimens from the patients with anastomotic recurrence, at resection margins sialomucin predomination was found in 18 cases, sulfomucin predomination in 4 cases, mix-mucin predomination in 6 cases. Among other 32 specimens from patients with no an-astomotic resvurrence, at the resection margins sialomucin predomination was found in 4 cases, sulfomucin predomination in 19 cases, mix-mucin predomination in 9 cases. There is a significant statical difference between the two groups (P<0.001). Therefore the transitional mucosa is believed to be a factor affecting anastomotic recurrence after curative surgery of large bowel carcinoma Through the research of the significance of transitional mucosa, the concept of the curative surgery of large bowel carcinoma may be changed.