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目的 探讨直肠癌旁移行粘膜的性质及其与术后吻合口癌肿复发的关系。 方法 应用粘液组织化学、免疫组织化学技术和图像细胞光度计 (ICM)对 6 7例直肠癌手术切除标本及其近、远端肠管粘膜及 33例术后 1年、31例术后 2年以上直肠粘膜病理活检标本 (吻合口至其下 3cm)同步检测其 p2 1ras、p5 3蛋白表达率 ,增殖细胞核抗原 (PCNA )指数及DNA含量和倍体变化。 结果 (1)高铁二胺 -阿辛蓝 (HID-AB,p H2 .5 )染色 :近切端中无 级以上唾液酸粘蛋白反应 ,癌组织中 级以上唾液酸粘蛋白反应占 5 3.7% ,远切端 TM阳性率为 14.9% ,高于近切端 (P<0 .0 1) ,术后复查 TM阳性率与远切端相比增高 (1年为 39.4% ,2年以上为 32 .3% ,P<0 .0 0 1)。 (2 ) p2 1ras蛋白表达 :近切端粘膜无 p2 1ras蛋白表达 ,癌组织为 6 1.2 % ,远切端 (13.4% )高于近切端 (P <0 .0 1) ,但在远切端正常粘膜和 TM中表达无差异 (P>0 .0 5 ) ,术后复查与远切端相比有下降趋势 (术后 1年9.1% ,2年以上 3.2 % ,P<0 .0 5 )。 (3) p5 3蛋白表达 :近切端粘膜无 p5 3蛋白表达 ,癌组织为 5 9.7% ,远切端 (7.5 % )高于近切端 ,但统计学意义不显著 (P>0 .0 5 ) ,术后复查与远切端相比阳性率降低 ,1年为 6 .1% ,2年以上为 0 (0 /31) ,p5 3蛋白表达在远
Objective To investigate the nature of transitional mucosa adjacent to rectal cancer and its relationship with postoperative recurrence of anastomotic cancer. Methods Mucinous histochemistry, immunohistochemical technique and image cytometer (ICM) were used to examine the surgical specimens of 67 rectal cancers and its proximal and distal bowel mucosa and 33 cases of postoperative 1 year and 31 cases more than 2 years after operation. The rectal mucosal biopsy specimens (3 cm below the anastomosis) were simultaneously tested for p21ras, p53 protein expression, PCNA index, DNA content, and ploidy changes. Results (1) High iron diamine-alcian blue (HID-AB, p H2 .5) staining: sialic acid mucins were more than graded in the proximal end of the cut, and the sialyl mucoprotein response in the middle and upper stages of cancer tissues accounted for 5 3.7%. The positive rate of cut-end TM was 14.9%, which was higher than that of the proximal cut-end (P<0.01). The positive rate of TM examination after surgery was higher than that of the distal cut (39.4% for 1 year and 32.3% for 2 years or more). <0. 0 0 1). (2) p2 1ras protein expression: There was no p21ras protein expression in the proximal mucosa, 61.2% of cancer tissues, distal (13.4%) higher than proximal (P < 0.01), but normal mucosa in the distal end There was no difference in TM expression (P>0.05), and the postoperative review had a decreasing trend compared with the distal end (9.1% postoperatively, 3.2% over 2 years, P<0.05). (3) p53 protein expression: There was no expression of p53 protein in the proximal mucosa, the cancer tissue was 5 7%, and the distal cut end (7.5%) was higher than the proximal cut end, but the difference was not statistically significant (P> 0.05). The positive rate of postoperative reexamination was lower than that of the distal extremity, with a rate of 6.1% at 1 year, 0 (0/31) at 2 years, and p53 protein expression in the distal