早期胃癌组织形态,细胞核DNA含量及免疫组织化学研究

目的:对早期胃癌病理形态、细胞核DNA含量、免疫组化及治疗等进行讨论。方法:32例早期胃癌,采用S-P法免疫组化,观察p53、p21、CEA、PCNA的表达;细胞核DNA含量以及组织病理学特征。结果:早期胃癌癌周围粘膜常伴有绒毛状异型增生、腺瘤状异型增生、囊腺样异型增生、球样异型增生、灶性异型增生的形态,并与相应腺癌一致。细胞核DNA含量,异倍体细胞在6.8％～79.5 ％之间;PCNA阳性细胞数在24.7～93.2个之间;p53、p21基因蛋白和CEA阳性表达分别为37.5％、78.1％和93.8％。早期胃癌经微波治疗后,近期经手术切除的标本中75％(6/8)仍有癌细胞存在。结论:早期胃癌与癌前期异型增生的组织学形态密切相关;异倍体值、细胞增殖指数、p53、p21和CEA表达,有助于癌前病变和早期胃癌的诊断;早期胃癌以手术切除为宜。

DNA Content and Immunohistochemical Studies on Early Gastric Cancer

Aims: The histopathology, DNA content, immunohistochemistry and therapy of early gastric cancer were studied. Methods: 32 cases of early gastric cancer were detected in DNA content, histopathology change and expression of p53, p21, CEA and PCNA with S-P immunohistochemical staining. Results: Adjacent mucosa of early gastric cancer could be accompanied by histopathology changes of glandular atrophy and expansion, gastric gland casing, villous dysplasia and focal dysplasia. Number of aneuploid cells and DNA content showed from 6.8% to 79.5% . The positive rates of PCNA were from 24.7% to 93.2% . The positive rates of p53, p21 and CEA was 37. 5%, 78.1% and 93.8% respectively. Cancerous tissues were still found in those cases after microwave therapy(75%). Conclusions: Early gastric cancer is closely associated with histomor-phology of precarcino-matous dysplasia. PCNA, aneuploid value, expression of p53, p21 and CEA are heplful for the diagnosis of early gastric cancer and precancerous lesions.