大肠癌沿肠管纵向浸润范围的形态学测量及免疫组化研究

应用ＰＡＰ法对６０例大肠癌、癌旁粘膜及正常粘膜进行了癌胚抗原（ＣＥＡ）的免疫组化检测，对大肠癌沿肠管的纵向浸润范围进行了形态学测量。结果显示，ＣＥＡ在大肠癌组织阳性率为９６．７％，明显高于癌旁粘膜及正常粘膜（Ｐ＜０．０１），低分化腺癌ＣＥＡ阳性率明显高于乳头状腺癌和腺癌１级。大肠癌ＣＥＡ阳性程度与沿肠管纵向浸润距离无关。本组病例４１％沿肠管纵向浸润距离在瘤体下缘０．５ｃｍ内，７８％浸润１ｃｍ内，仅１．７％浸润达瘤体下缘２ｃｍ以上。肿瘤浸润越深，纵向浸润距离越大（Ｐ＜０．０１）。浸润方式主要有直接蔓延和淋巴管栓塞。大肠癌沿肠等纵向浸润距离很少超过２ｃｍ，可作为大肠癌手术切除范围的理论依据。

HISTOMORPHOMETRY OF THE LONGITUDINAL INVADING OF COLORECTAL CANCER INTO THE SUBMUCOSA OF LARGE AND IMMUNOHISTOCHEMISTRY DETECTION OF CEA

The expression of CEA in colorectal cancer tissues and the mucosa adjacent and nomal of 60 cases were studied with PAP method,and the longitudinal invading into the subucosa of the large intestine was measure with micrometer.The results showed that CEA positive rate in colorectal cencer tissues was 96.7% which was significantly higher than that in tissues of the mucosa adjacent to the cancer and nomal mucosa(P<0.01).In the 60 cases of colorectal carcinoma,the range of longitudinal invading less than 0.5 cm was 41%,less than 1 cm was 78%,2 cm or more only 1.7%.The deeper invaded into intestine wall,the farther invaded along the long axial.There were two types of the longitudinal invading direct spread and embolism in lymph tube It is considered that CEA may be used as an immunohistochemical marker in the study of colorectal cancer.The longitudinal invading of colorectal cancer is rarely more than 2 cm which would provide theortical fondation for the surgical removal of the large intestinal cancer.