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目的:对口腔鳞癌癌周组织中细胞的DNA倍性、S期比率(SPF)、增殖指数(PI),以及e IF4E的表达进行分析,以探讨合理的口腔鳞癌手术安全切缘。方法:将口腔鳞癌癌灶中心、癌周0~0.5 cm、0.5~1.0 cm、1.0~1.5 cm、1.5~2.0 cm组织标本分别设为T、P1、P2、P3、P4组。正常口腔黏膜标本设为N组。应用流式细胞仪对标本中DNA倍性、S期比率、增殖指数进行分析,采用免疫组化方法对标本中e IF4E的表达进行检测,并采用SPSS13.0软件包对数据进行统计学分析。结果:在P1、P2、P3、P4组中,异倍体率、SPF、PI呈逐渐下降趋势。N组均为二倍体,其异倍体率、SPF和PI与T、P1、P2、P3、P4组均有显著差异。e IF4E在P1、P2、P3、P4组中呈递减趋势,而在P4组中阳性表达率仍达30%,与N组差异显著(P<0.01)。结论:口腔鳞癌癌周组织的异倍体率、SPF、PI各参数以及e IF4E的表达随着离癌灶距离的增加呈下降趋势,但到癌周2.0 cm时,仍然与正常口腔黏膜有显著差异。有条件时,手术要尽量将口腔鳞癌的手术切缘扩大到癌周2.0 cm以外;如无法达到,则需通过术后综合治疗防止肿瘤复发。
OBJECTIVE: To analyze the DNA ploidy, S phase ratio (SPF), proliferation index (PI) and eIF4E expression in oral squamous cell carcinoma of the oral cavity in order to explore the reasonable safety margin of oral squamous cell carcinoma. Methods: Tissues from 0 to 0.5 cm, 0.5 to 1.0 cm, 1.0 to 1.5 cm and 1.5 to 2.0 cm in the center of tumor and periocancerous tissues of oral squamous cell carcinoma were randomly divided into T, P1, P2, P3 and P4 groups. Normal oral mucosa specimens were set as N group. The DNA ploidy, S phase ratio and proliferation index of the samples were analyzed by flow cytometry. The expression of e IF4E in the samples was detected by immunohistochemistry. The data were analyzed by SPSS13.0 software package. Results: In the P1, P2, P3, P4 groups, aneuploidy rate, SPF, PI showed a gradual downward trend. N group were diploid, the aneuploidy rate, SPF and PI and T, P1, P2, P3, P4 group were significantly different. e IF4E showed a decreasing trend in P1, P2, P3 and P4 groups, while the positive expression rate in group P4 still reached 30%, which was significantly different from that in group N (P <0.01). CONCLUSIONS: The aneuploidy rate, SPF, PI parameters and eIF4E expression in oral squamous cell carcinoma of the oral squamous cell carcinoma of the oral cavity decrease with the increase of the distance from the cancerous lesion. However, Significant differences. When conditions permit, the operation should try to expand the surgical margin of oral squamous cell carcinoma to the periapical week 2.0 cm; if can not be achieved, then through the postoperative comprehensive treatment to prevent tumor recurrence.