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为了探讨核仁组成区嗜银蛋白(nucleolar organizer region;AgNOR)检测对良、恶性溃疡的鉴别及可疑恶变溃疡的临床随访、二次活检的辅助指导价值,对58例经首次胃镜检查可疑恶性溃疡、活检病理未能确诊为胃癌的患者,进行AgNOR银染法染色并行图像分析检测后,密切临床随访,随访时间1～72周(平均7周)。所有患者均再次胃镜复查,组织活检,病理检查。结果表明,AgNOR每核平均颗粒数≥7.0的30例中19例二次活检病理检查确诊为胃癌(63.3%),AgNOR每核平均颗粒数<7.0的28例中5例确诊为胃癌(17.9%),两组胃癌检出率差异有非常显著意义(P<0.01)。结论:AgNOR颗粒数量增多与胃癌关系密切,对AgNOR每核平均颗粒数≥7.0的患者进行密切随访,有助于胃癌的早期发现。
To investigate the value of nucleolar organizer region (AgNOR) detection in the differential diagnosis of benign and malignant ulcers and the clinical follow-up and secondary biopsy of suspicious malignant ulcers, 58 cases of suspicious malignant ulcers after the first gastroscopy were performed. Patients with undiagnosed gastric cancer in biopsy pathology were followed up by AgNOR silver staining and parallel image analysis. Follow-up time was 1 to 72 weeks (average 7 weeks). All patients were re-examined by gastroscopy, biopsy, and pathological examination. The results showed that 19 out of 30 cases with AgNOR average number of particles ≥ 7.0 were confirmed as having gastric cancer (63.3%) by secondary biopsy, and 5 of 28 cases with AgNOR average number of particles less than 7.0 were diagnosed with gastric cancer (17.9%). The difference between the two groups in the detection rate of gastric cancer was very significant (P<0.01). Conclusion: The increased number of AgNOR particles is closely related to gastric cancer. Close follow-up of AgNOR particles with average number of particles per nucleus≥7.0 will help early detection of gastric cancer.