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目的探讨细胞增生与凋亡在大肠癌组织及不同部位黏膜细胞中的改变以及二者与预后关系。方法76例大肠癌标本分别取癌组织(cancer m ucosa,C M)、癌近旁组织(cancer adjacent m ucosa,C AM)、癌远旁组织(cancer distant m ucosa,C D M),进行PC N A和Fas染色,并进行随访。结果PC N A在C M中表达高于C AM(P<0.05)及C D M(P<0.01)。C AM Fas染色阳性率为67.1%,高于C D M(42.1%)(P<0.05)及C M(32.9%)(P<0.01)。47例完整随访患者中22例死亡。其中,15例癌组织PC N A高表达,与对照组差异无显著性(P>0.05);14例Fas表达阴性者平均生存期同对照组相比差异无统计学意义(P>0.05)。然而,PC N A高表达同时Fas表达阴性的9例患者平均生存期比同组对照缩短(P<0.01)。结论细胞的增生活性是以肿瘤组织为中心逐渐递减,而细胞凋亡在癌近旁组织明显增强。单纯肿瘤增生或凋亡与肿瘤患者生存时间无显著相关,较高的细胞增生同时伴凋亡下降则可能预示患者预后较差。
Objective To investigate the changes of cell proliferation and apoptosis in colorectal cancer tissues and different parts of mucosal cells and their relationship with prognosis. Methods Totally 76 cases of colorectal cancer specimens were taken from cancer tissue (CM), cancer adjacent m ucosa (C AM) and cancer distant m ucosa (CDM) , And follow-up. Results PC N A expression in C M was higher than C AM (P <0.05) and C D M (P <0.01). The positive rate of C AM Fas staining was 67.1%, higher than that of C D M (42.1%) (P <0.05) and C M (32.9%) (P <0.01). Twenty-two of 47 complete follow-up patients died. Among them, PCN A was highly expressed in 15 cases of cancerous tissue, but there was no significant difference between the two groups (P> 0.05). The average survival time of 14 cases with negative expression of Fas was not significantly different from that of the control group (P> 0.05). However, the mean survival time of 9 patients with high PCNA expression and negative Fas expression was shorter than that of the control group (P <0.01). Conclusion The proliferative activity of the cells gradually decreases with the tumor tissue as the center, while the apoptosis of the cells is obviously enhanced in the vicinity of the cancer. Simple tumor proliferation or apoptosis and tumor survival time was not significantly correlated, higher cell proliferation accompanied by decreased apoptosis may indicate that patients with poor prognosis.