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目的:从三维水平定量揭示大肠腺癌、腺瘤及正常粘膜上皮线粒体的超微结构特点和变化规律,并阐明其能量代谢的主要途径。方法:手术大肠腺癌8例,肠镜大肠腺瘤8例,大肠癌正常粘膜8例。按体视学原理和方法在电镜下随机摄片,以胞浆为参照空间,测试腺上皮细胞中形态正常的和空泡变性的线粒体的体积密度（Vv）、表面积密度（Sv）、数密度（Nv）、平均自由程（λ）、形状因子（PE）、改良形状因子（pe）、规化形状因子（RFF）、平均体积（v）及平均表面积（s）,比较这些参数在不同组织间的差异。结果:正常线粒体的 SV、NV、pe、RFF在大肠腺癌、腺瘤和正常粘膜之间差异有显著性（P<0.05）;空泡化线粒体比较,三组间Vv、Sv、λ、PE、pe、RFF、v、s差异有显著性（P<0.05）;全部线粒体比较,三组间Nv差异有显著性（P<0.05）。结论:大肠腺瘤线粒体增生明显,其生物氧化产能功能的结构基础较腺癌和正常组织增大,糖代谢以有氧代谢为主;大肠腺癌癌细胞线粒体减少,生物氧化产能功能的结构基础较正常及腺瘤减弱,糖代谢以无氧酵解为主;线粒体空泡化普遍存在于大肠腺癌、腺瘤和正常组织中,其形态更趋向于圆形。
OBJECTIVE: To quantitatively reveal the ultrastructural features and changes of mitochondria in colorectal adenocarcinoma, adenoma and normal mucosa epithelium from the three-dimensional level and clarify the main ways of energy metabolism. Methods: 8 cases of colon adenocarcinoma, 8 cases of colon adenoma, 8 cases of normal colorectal mucosa. According to the principle and method of stereology, the radiographs were taken under the electron microscope and the cytoplasm was taken as reference space to test the density, volume density (Vv), surface area density (Sv) and number density of normal and vacuolar degeneration mitochondria in glandular epithelial cells (Nv), average free path (λ), shape factor (PE), modified shape factor (pe), normalized shape factor (RFF), average volume (v) and average surface area The difference between. Results: The differences of SV, NV, pe, RFF in normal mitochondria between colorectal adenocarcinoma, adenoma and normal mucosa were significant (P <0.05). Compared with mitochondria, Vv, Sv, , Pe, RFF, v, s (P <0.05). There was a significant difference in Nv between the three groups (P <0.05) in all mitochondria. Conclusions: The mitochondrial hyperplasia of colorectal adenoma is obvious. The structural basis of its biological oxidative capacity is larger than that of adenocarcinoma and normal tissue, and the main metabolism of carbohydrate is aerobic metabolism. The structural basis of mitochondrial reduction and bio-oxidative capacity of colorectal adenocarcinoma Compared with normal and adenoma, glucose metabolism is dominated by anaerobic digestion; mitochondria vacuolization is common in colorectal adenocarcinoma, adenoma and normal tissues, and its morphology tends to be round.