子宫颈上皮癌前病变及子宫颈癌的细胞核

目的探讨宫颈上皮癌变过程中的细胞生物学特征及其变化规律,为临床诊治提供依据.方法收集125份宫颈组织行病理检查,按病变程度不同分为,正常宫颈上皮11份、宫颈上皮内瘤变Ⅰ级(CINⅠ)22份、宫颈上皮内瘤变Ⅱ级(CINⅡ)17份、宫颈上皮内瘤变Ⅲ级(CINⅢ)13份和宫颈鳞癌55份(其中高、中、低分化宫颈鳞癌分别为13、19、23份),以及宫颈腺癌7份.组织切片分别行福根(Feulgen)染色,并以计算机检测其DNA平均倍体值(DMP)、DNA指数(DI)、核面积,打印DNA倍体直方图.结果(1)随病变程度增高,DMP、DI和核面积测定值均依次逐渐增高,正常宫颈上皮与CINⅠ、CINⅡ3者间比较,除正常宫颈上皮与CINⅡ的DI和核面积、CINⅠ与CINⅡ的核面积比较,差异有显著性(P＜0.05)外,其余差异均无显著性(P＞0.05);而宫颈癌与CINⅠ、CINⅡ比较,差异均有极显著性(P＜0.01);高、中、低分化宫颈鳞癌3者间比较,差异也均无显著性.(2)官颈不同病变的DNA倍体直方图各有特点,超5倍体(5C)细胞在CINⅢ病变组织中开始增多,5C、7C和9C细胞在鳞癌病变组织中显著增加.结论宫颈上皮癌变是一个渐进的、由量变到质变的过程.CINⅢ是非癌到癌的变化阶段.

Study on nuclear DNA content and image cytometry in cervical cancer and precursor lesions

OBJECTIVE: The aim of this research was to study the biological and clinical features of cervical cancer and precursor lesions. METHODS: Nuclear DNA was analyzed by image cytometry (ICM) in 125 embedded tissue 5 microns sections stained with Feulgen stain. Samples included normal cervical squamous epithelium (n = 11), cervical intraepithelial neoplasia I (CIN I) (n = 22), CINII (n = 17) and CINIII (n = 13), cervical neoplasm (n = 62). RESULTS: The mean DNA content, nuclear area increased progressively from normal cervical epithelium, CINI, CINII, CINIII to invasive squamous carcinoma. Statistical analysis revealed significant difference (P < 0.05, < 0.01). Histograms of cellular DNA ploidy distribution showed different pattern, where 9 components (9C) cells were observed in cervical cancer and CINIII. No differences in DNA mean ploidy (DMP), DNA index (DI) and nuclear area were observed between cervical neoplasm. CONCLUSIONS: It is increased progressively from normal cervical epithelium to cancer, in which CINIII is turning point.