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目的:对早期胃癌病理形态、细胞核DNA含量、免疫组化及治疗等进行讨论。方法:32例早期胃癌,采用S-P法免疫组化,观察p53、p21、CEA、PCNA的表达;细胞核DNA含量以及组织病理学特征。结果:早期胃癌癌周围粘膜常伴有绒毛状异型增生、腺瘤状异型增生、囊腺样异型增生、球样异型增生、灶性异型增生的形态,并与相应腺癌一致。细胞核DNA含量,异倍体细胞在6.8％～79.5 ％之间;PCNA阳性细胞数在24.7～93.2个之间;p53、p21基因蛋白和CEA阳性表达分别为37.5％、78.1％和93.8％。早期胃癌经微波治疗后,近期经手术切除的标本中75％(6/8)仍有癌细胞存在。结论:早期胃癌与癌前期异型增生的组织学形态密切相关;异倍体值、细胞增殖指数、p53、p21和CEA表达,有助于癌前病变和早期胃癌的诊断;早期胃癌以手术切除为宜。
Objective: To discuss the pathological morphology, nuclear DNA content, immunohistochemistry and treatment of early gastric cancer. Methods: Thirty-two cases of early gastric cancer were immunohistochemically stained with S-P to observe the expression of p53, p21, CEA and PCNA, and their nuclear DNA content and histopathological features. RESULTS: The surrounding mucosa of early gastric cancer was often accompanied by villous dysplasia, adenoma-like dysplasia, cystic adenoid hyperplasia, dysplasia and focal dysplasia, and was consistent with the corresponding adenocarcinoma. The nuclear DNA content was between 6.8% and 79.5% for aneuploid cells, 24.7 to 93.2 for PCNA positive cells, and 37.5%, 78.1%, and 93.8% for p53, p21, and CEA, respectively. After microwave treatment of early gastric cancer, 75% (6/8) of the recently surgically resected specimens still had cancer cells. Conclusion: The early gastric cancer is closely related to the histological morphology of precancerous dysplasia. The expression of aneuploidy, cell proliferation index, p53, p21 and CEA are helpful for the diagnosis of precancerous lesions and early gastric cancer. should.