直肠癌旁移行黏膜P21\P53蛋白表达及其对保肛术的影响(1)
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【摘要】 目的研究直肠癌癌旁黏膜p21、p53蛋白的表达,探讨对直肠癌切缘距离的临床意义。方法 应用免疫组化方法检测34例直肠癌癌旁移性黏膜中p21、p53蛋白表达。结果 ①直肠癌远端扩散有9例,占29.4%,远端扩散距离均在2 cm以内;②34例直肠癌标本其癌组织远端均表现为癌旁黏膜,其癌旁黏膜的距离均未超过4 cm;③P53蛋白在癌组织中表达阳性为20例,阳性率为58.6%;在癌旁表达为10例,阳性率为29.3%。同时资料表明两者之间无显著性差异;④P21蛋白在癌组织中表达阳性为21例,阳性率为 61.5%;在癌旁组织表达为9例,阳性率为26.4%。同时资料表明两者之间无显著性差异。结论 直肠癌远端肠管移性黏膜2~4 cm处于癌前病变状态,建议远端切除距离应更长些。
【关键词】直肠癌;直肠癌旁移行黏膜;P21蛋白;P53蛋白
Expression of p21and p53 protein in the transitional mucosa adjacent to rectal cancer and its effect on anus-preserving operation
HU Man-li,FAN En-xue,SUN Hai-xia.Changchun Medical College,ChangChun130031,China
【Abstract】 Objective To study the expression of p21and p53 in the mucosa adjacent to the rectal cancer,we discuss the affection of the mucosa adjacent to the cancer that which distance is safe for the distal edge in rectal cancer dissection.Methods The immunohistochemical research has shown the expression of p21and p53 in mucosa adjacent to the cancer,and the samples came from the 34 patients who had got dissection for rectal cancer.Results ①It was 9 samples who had had distal diffused,the ratio is 29.4%,the distance of the distal diffusion were all inner 2 cm.②All 34 samples of tumor body had the same manifestation,they showed the mucosa adjacent to cancer.In all samples I had studied,the distance of mucosa adjacent to cancer were all inner 4 cm.③There were 20 samples who got p53 positive in the tumor body,positive rate is 58.6%;And the number p53 positive in the tissue of the cancer were 9,it is 26.4%.It had no difference between them from data analysis.Conclusion There are 2~4 cm pre-carcinoma pathological stage.It is suggested that the dissection distance of the distal bowel in the rectal cancer should be long enough.
【Key words】Rectal cancer; Transitional mucosa adjacent to rectal cancer; p21protein; p53 protein
作者单位:130031长春医学高等专科学校/吉林大学第二医院/吉林大学第一医院
直肠癌保肛术远端切除多少厘米[1]才能不复发,一直是外科争论的焦点,本研究通过检测癌旁移行黏膜P21、P53蛋白表达,探讨分子切缘的临床意义。
1 材料与方法
1.1 材料 收集吉林大学第二医院2002年12月至2004年1月基本外科直肠癌根治术标本34例,其中男20例,女14例,年龄(50±11.8)岁。按统一分类为:高分化腺癌6例,中等分化腺癌15例,低分化腺癌6例,粘液腺癌7例 ......
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