食管鳞状细胞癌切除标本切缘组织的DNA 倍体和增殖活性(英文)

目的　探讨食管癌切除标本切缘组织的细胞生物学特性与术后复发的关系。方法　采用ＦＡＣＳ－ ４２０ 型流式细胞仪对３３ 例切缘组织，１０ 例主体癌和５ 例正常食管粘膜组织的ＤＮＡ 含量（ＤＩ）和增殖指数（ＰＩ） 进行了定量测定，并与患者的术后生存情况进行相关分析。结果　切距（ 主体癌上缘与上切缘之间的距离）＜ ５ｃｍ 的切缘，不典型增生性切缘及癌残留切缘的ＰＩ值显著高于≥５ｃｍ 切缘和正常粘膜；而且５ 年生存率也显著低于≥５ｃｍ 切缘的患者。尤其有意义的是，１２ 例＜ ５ｃｍ 的切缘组织中，有２ 例异倍体出现，９ 例ＰＩ＞ ２０％ 。另一个发现是，切缘残留癌的ＤＩ显著低于相应的主体癌。结论　①检测切缘ＤＮＡ 含量和ＰＩ有助于判断患者预后；②切缘残留癌的增殖活性低于主体癌，这将为术后早期治疗残留癌及预防复发提供机会。

DNA content and proliferative activity of resected margin of the esophagectomy specimens for squamous cell carcinoma

Objective To search for relationship between biologic characteristics of resected margin ofthe esophagectomy specimens and local recurrence in esophageal squamous cell carcinoma. Methods DNA contents (DNA index, DI) and proliferative index (PI) were measured by flow cytometry analyzer (FACS-420) for 33 samples of resected margin with verious histological changes , 5 normal esophageal mucosa and 10 primary tumor, and a relative analysis was performed between the DI and PI measured and patient's survival. Results In<5cm group , PI was higher than that in ≥5cm group and normal group , and similar to dysplasia group and residual tumor (RT) group; and 2 aneuploid DNA histograms were found .Of 12 samples in <5cm group, 9 have a high PI (>20%), The rate of survival in this group was lower than that in ≥5cm . An another finding in the present study was that DI and PI in RT group was lower than those in primary tumor group.Conclusion (1)measuring of DI and PI of resected margins by FCM may aid doctors` assessing patient's prognosis and local recurrence; (2) the proliferative activity of RT is lower than that of corresponding primary tumor,which will provide an opportunity to early treat RT and prevent recurrences in clinical practice after operation.