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目的提高直肠癌术前活检的诊断率。方法5年来手术治疗的168例直肠癌病人中，有20例（11．9％）第一次手术前活检不能明确诊断。对其中17例患者的活检组织石蜡标本（实验组）和10例正常肠粘膜活检标本（对照组）进行常规病理、P53与ras癌基因产物检测。结果实验组中P53与ras基因表达阳性率分别为71％与47％，阳性率均高于常规病理，有显著性差异。17例标本中，11例为不典型增生，5例仅有慢性炎症。不典型增生的P53与ras基因表达分别为11例和7例，而慢性炎症则全部为阴性。二者之间，两种基因表达阳性率均有显著差异。实验结果还显示P53与ras基因表达有较好的一致性。对照组的10例正常肠粘膜的活检标本P53与ras基因检测结果均阴性，与实验组比较，P53阳性率有显著差异。结论P53与ras基因表达检测，可以作为常规病理的补充，提高直肠良恶性病变的鉴别力。
Objective To improve the diagnostic rate of preoperative biopsy of rectal cancer. Methods Of 168 patients with rectal cancer who underwent surgery for 5 years, 20 (11.9%) had no definite diagnosis of the first preoperative biopsy. The routine pathology, P53 and ras oncogene products were detected in 17 cases of biopsied paraffin specimens (experimental group) and 10 cases of normal intestinal mucosa biopsy specimens (control group). Results The positive rates of P53 and ras in experimental group were 71% and 47%, respectively. The positive rates of P53 and ras in experimental group were higher than those in routine pathology, with significant difference. Of the 17 specimens, 11 were atypical hyperplasia and 5 had chronic inflammation. Atypical hyperplasia of P53 and ras gene expression were 11 cases and 7 cases, while chronic inflammation were all negative. Between the two, the positive rates of the two genes were significantly different. The experimental results also showed that P53 and ras gene expression has a good consistency. The control group of 10 cases of normal intestinal mucosa biopsy specimens P53 and ras gene test results were negative, compared with the experimental group, P53 positive rate was significantly different. Conclusion The detection of P53 and ras gene expression can be used as a routine pathological supplement to improve the differential diagnosis of benign and malignant rectal lesions.