Nsien E, Steinberg W M, Wilkinson D S, Rhame J G, Henry J P
Department of Medicine, George Washington University Medical Center, Washington, DC.
Am J Gastroenterol. 1991 Oct;86(10):1477-81.
We wished to determine whether DNA flow cytometric analysis could detect DNA abnormalities in normal-appearing mucosa of patients with colonic neoplasia. Eighty-five patients were studied either at colonoscopy or at surgical resection. Forty-five had macroscopically normal colonoscopy; 13 had adenomatous polyps, and 27 had colorectal carcinoma. Biopsies were obtained from the cancer and from normal-appearing mucosa 5 cm from the lesion. The patients who had normal colonoscopy had rectal biopsies. The samples were prepared for analysis on a Coulter EPICS C flow cytometer. Cells were analyzed for presence of aneuploidy (%AN), percent in DNA synthetic phase (%S), and percent growth fraction (%GF = %S + %G2M). Aneuploidy was present in 12 of 27 carcinomas (44%), but in none of the samples from polyps or normal-appearing colorectal mucosa adjacent to cancers. The %S from cancers was greater than those from polyps (9.6 +/- 6.3 vs. 5.1 +/- 1.8, p less than 0.005). However, %S from specimens arising from normal-appearing mucosa 5 cm distant from cancer could not be differentiated from the rectal mucosa of macroscopically normal colons (5.9 +/- 2.5 vs. 5.2 +/- 2.7). The %GF of cancer specimens was greater than those from adenomas (26.0 +/- 11.0 vs. 10.8 +/- 3.7, p less than 0.005). However, the %GF of normal-appearing mucosa 5 cm distant from the cancer was similar to the findings from mucosa arising from macroscopically normal colons (10.5 +/- 3.3 vs. 11.0 +/- 3.4). In conclusion, DNA flow cytometric analysis of normal-appearing colonic mucosa from patients with colonic carcinoma does not demonstrate abnormalities of DNA content or cell cycle kinetics, and therefore, cannot predict the presence of colonic neoplasia.
我们希望确定DNA流式细胞术分析能否检测出结肠肿瘤患者外观正常的黏膜中的DNA异常。对85例患者进行了结肠镜检查或手术切除研究。45例患者结肠镜检查时黏膜外观正常；13例有腺瘤性息肉，27例有结直肠癌。从癌组织以及距病变5厘米处外观正常的黏膜获取活检样本。结肠镜检查正常的患者取直肠活检样本。样本经处理后在库尔特EPICS C流式细胞仪上进行分析。分析细胞的非整倍体比例（%AN）、DNA合成期比例（%S）以及生长分数比例（%GF = %S + %G2M）。27例癌组织中有12例（44%）存在非整倍体，但息肉或癌旁外观正常的结直肠黏膜样本中均未发现。癌组织的%S高于息肉组织（9.6±6.3对5.1±1.8，p<0.005）。然而，距癌组织5厘米处外观正常的黏膜样本的%S与结肠镜检查外观正常的结肠直肠黏膜的%S无法区分（5.9±2.5对5.2±2.7）。癌组织样本的%GF高于腺瘤组织（26.0±11.0对10.8±3.7，p<0.005）。然而，距癌组织5厘米处外观正常的黏膜的%GF与结肠镜检查外观正常的结肠黏膜的结果相似（10.5±3.3对11.0±3.4）。总之，对结肠癌患者外观正常的结肠黏膜进行DNA流式细胞术分析未显示DNA含量或细胞周期动力学异常，因此无法预测结肠肿瘤的存在。
