瘤体内DNA倍体异质性与食管鳞状细胞癌病理特性的关系

目的探讨食管鳞状细胞癌瘤体内ＤＮＡ倍体异质性及其与肿瘤病理学特性的关系。方法采用多点取材方法，应用流式细胞术对８０例中晚期食管鳞癌标本的ＤＮＡ倍体类型进行分析。如果一个标本中的３个样品中的倍体类型不一致，即判定为倍体异质性肿瘤（ＰＨＴ），其余为非倍体异质性肿瘤（Ｎ－ＰＨＴ）。然后用统计学方法分析ＤＮＡ倍体异质性与肿瘤病理学特性的关系。结果８０例中，共检出异倍体肿瘤７１例（８８．８％），ＤＮＡ指数范围为０．７７～１．７４。倍体异质性肿瘤的检出率为４７．５％（３８／８０）。倍体异质性与肿瘤的侵润程度，淋巴结转移及患者预后有关（Ｐ＜０．０５～０．０２５），而与组织分级和瘤体大小无关（Ｐ＞０．０５）。结论ＤＮＡ倍体异质性是一种重要的肿瘤生物学现象。深入研究它将对判断肿瘤的病理特性、患者预后及协助组织学分级具有重要的价值。

Relationship between intratumoral heterogeneity in DNA ploidy and pathological characteristics in esophageal squamous cell carcinoma

Objective To search for the intratumoral heterogeneity in DNA ploidy and its relation to pathological characteristics of esophageal carcinoma.Method The intratumoral heterogeneity in ploidy was analyzed by flow cytometry (FCM) with a method of multiple sites sampling in 80cases of squamous cell carcinoma of the esophagus. The tumor was considered as a ploid heterogeneous tumor (PHT) when different ploid patternts were present in 3 samples taked from a same tumor, and others were called non-PHT (N-PHT) .Then, a statistical method was used to analyze the relationship between ploid heterogeneity and pathologcal characteristics of tumor.Results Of 80 cases, 71 cases showed as aneuploid tumors (88.8%) .DNA indeces ranged from 0. 77 to 1. 74, the incidence of PHT was 47. 5% (38/ 80). The heterogeneity in DNA ploidy was related to the extent of wall penetration by tumor, the incidence of lymph nodemetastsais and patient's prognosis (P< 0.05- 0.025), and not to histological grades and size of tumor (P>0.05).Conclusion The heterogeneity about DNA ploidy is an importent biological event. The study about this may have an importent signifcance in aid to determine pathological characteristics,patient's prognosis and histological grades.