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目的 探讨大肠癌从大肠腺瘤伴轻度不典型增生到重度不典型增生到腺癌发展过程中肿瘤血管生成、细胞增殖、细胞凋亡的变化及其内在联系。方法 应用免疫组化方法测定增殖细胞核抗原 (PCNA)和微血管密度 (MVD) ,用TUNEL法测定细胞凋亡。结果 ( 1)从腺瘤到腺癌的发展过程中 ,细胞增殖水平逐渐增高 ,细胞凋亡逐渐减少 ,MVD逐渐增多。而且腺瘤伴轻度不典型增生的肿瘤微血管与腺瘤伴重度不典型增生相比不仅形态上有差异 ,在数量差异也有显著性。 ( 2 )轻度不典型增生腺瘤PCNA与AI呈正相关性。 ( 3 )将所有大肠肿瘤作为一组分析 ,发现MVD与AI具有负相关性。结论 ( 1)血管生成抑制肿瘤细胞凋亡 ,促进肿瘤细胞增殖。 ( 2 )血管生成开关可能是在腺瘤伴轻度不典型增生向重度不典型增生和腺癌的转化过程中启动的
Objective To investigate the changes of tumor angiogenesis, cell proliferation and apoptosis in colorectal cancer from colorectal adenoma with mild atypical hyperplasia to severe atypical hyperplasia to the development of adenocarcinoma. Methods The proliferating cell nuclear antigen (PCNA) and microvessel density (MVD) were determined by immunohistochemistry. The apoptosis was measured by TUNEL method. Results (1) During the development of adenoma and adenocarcinoma, the cell proliferation gradually increased, the apoptosis decreased and MVD gradually increased. And adenoma with mild atypical hyperplasia of tumor microvessels and adenomas with severe dysplasia compared to not only the morphological differences in the number of differences are also significant. (2) There was a positive correlation between PCNA and AI in mild atypical hyperplastic adenoma. (3) Analysis of all colorectal tumors as a group revealed a negative correlation between MVD and AI. Conclusion (1) Angiogenesis inhibits tumor cell apoptosis and promotes tumor cell proliferation. (2) The angiogenic switch may be initiated during the transformation of adenomas with mild dysplasia to severe dysplasia and adenocarcinoma