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目的 :分析喉癌、切缘及正常组织的DNA倍体特征及细胞周期特征 ,结合病理检查探讨 5mm切缘安全性。方法 :采用流式细胞术 (FCM )检测 2 0例喉癌患者冻存的喉癌标本及其 5mm切缘的DNA含量 ,并与正常声门组织 (5例 )作对照 ,进行统计学分析 ;同时对部分喉癌标本及切缘组织 (0 .5cm)进行病理学观察 ,并与FCM测值进行比较。结果 :喉癌标本、切缘及正常组织的异倍体率分别为 6 0 % (12 / 2 0 )、15 % (3/ 2 0 )及 0。喉癌、切缘组织S期百分比分别为 2 0 .33± 6 .12及 12 .35± 3.81,DI值分别为 1.78± 0 .82及 1.0 7± 0 .0 4 ,PI值为 2 9.0 9±6 .8及 11.75± 3.75 ,差异均存在显著性意义 (P <0 .0 5 )。光镜下 3例 5mm切缘可见癌累积 ,表现为癌细胞的粘膜下浸润和以原位癌形式延伸 ,与FCM检查异倍体的出现表现出相对一致性。结论 :5mm切缘对早期喉癌是安全的 ,但当肿瘤侵犯到声门旁隙时 ,肿瘤易浸润粘膜下 ,5mm切缘是不安全的。
OBJECTIVE: To analyze the DNA ploidy and cell cycle characteristics of laryngeal cancer, margins and normal tissues and to explore the safety of 5 mm margins in combination with pathological examination. Methods: The frozen specimens of laryngeal carcinoma and their DNA of 5 mm margin were detected by flow cytometry (FCM) in 20 patients with laryngeal cancer and compared with normal glottis (5 cases) for statistical analysis. At the same time, some of the laryngeal cancer specimens and margin tissues (0.5 cm) were pathologically observed and compared with the FCM measurements. Results: The aneuploidy rates of laryngeal cancer specimens, margins and normal tissues were 60% (12/20), 15% (3/20) and 0 respectively. The percentages of S phase in laryngeal cancer and margin margin tissues were 20.33 ± 6.12 and 12.35 ± 3.81 respectively, and the DI values were 1.78 ± 0.82 and 1.0 7 ± 0. 04 respectively, with a PI value of 2 9.0 9 ± 6 .8 and 11.75 ± 3.75 respectively, there was significant difference (P <0.05). Under the light microscope, 3 cases of 5 mm margins of visible cancer accumulation, manifested as submucosal invasion of cancer cells and extended to carcinoma in situ, and the appearance of aneuploidy FCM showed relatively consistent. CONCLUSION: The 5 mm margin is safe for early laryngeal cancer. However, when the tumor infiltrates the glottic space, the tumor is easily infiltrated into the submucosa and the 5 mm margin is not safe.