Marrero J M, de Caestecker J S, Corbishley C M, McCormick C, Northfield T C
Department of Biochemical-Medicine, St. George's Hospital Medical School, London, England.
Cancer. 1996 Jan 1;77(1):19-24. doi: 10.1002/(SICI)1097-0142(19960101)77:1<19::AID-CNCR5>3.0.CO;2-I.
Gastric mucosal cellular DNA content was assessed in patients who had undergone gastric surgery for peptic ulcer disease more than 20 years previously, with the aim of examining the relationship between abnormal DNA content and gastric mucosal dysplasia, as well as determining the effect of different types of surgery on DNA content.
Sixty-five subjects underwent upper gastrointestinal endoscopy. In each, six biopsies were taken from the stoma or antrum and graded for severity of dysplasia. Cellular DNA was quantified using a microprocessor-controlled image analysis system with a fast densitometer card on Feulgen-stained slides. DNA histograms were evaluated using the 2c deviation index (2cDI) for proliferative activity and the 4c exceeding rate (4cER) and the 5c exceeding rate (5cER) as indices of malignant potential.
In subjects with Billroth II operations, all the above DNA criteria were higher than in Billroth I (P < 0.05), vagotomy and pyloroplasty (P < 0.001), and controls (P < 0.0001). DNA values increased as dysplasia progressed in severity (2cDI, Rs = 0.67; 4cER, Rs = 0.61; 5cER, Rs = 0.72; respectively, P < 0.0001). Among subjects with no dysplasia, more aneuploid cells were found in the Billroth II group, (p < 0.005) compared with the other types of operation.
Cellular DNA content is abnormal at an early stage in dysplasia and may even predate it. Increasing values of abnormal DNA content are related to the severity of dysplasia. DNA analysis may be a useful additional tool in surveillance programs to select high-risk patients for screening.
对20多年前因消化性溃疡疾病接受过胃部手术的患者的胃黏膜细胞DNA含量进行评估，目的是研究异常DNA含量与胃黏膜发育异常之间的关系，并确定不同类型手术对DNA含量的影响。
65名受试者接受了上消化道内镜检查。对每例受试者，从吻合口或胃窦取6块活检组织，并对发育异常的严重程度进行分级。使用带有快速密度计卡的微处理器控制图像分析系统对福尔根染色玻片上的细胞DNA进行定量。使用2c偏差指数（2cDI）评估DNA直方图的增殖活性，使用4c超标率（4cER）和5c超标率（5cER）作为恶性潜能指标。
在接受毕罗Ⅱ式手术的受试者中，所有上述DNA标准均高于毕罗Ⅰ式手术（P < 0.05）、迷走神经切断术加幽门成形术（P < 0.001）和对照组（P < 0.0001）。随着发育异常严重程度的进展，DNA值升高（2cDI，Rs = 0.67；4cER，Rs = 0.61；5cER，Rs = 0.72；P均< 0.0001）。在无发育异常的受试者中，与其他类型手术相比，毕罗Ⅱ式手术组发现的非整倍体细胞更多（P < 0.005）。
发育异常早期细胞DNA含量即出现异常，甚至可能在发育异常之前就已出现。异常DNA含量值的增加与发育异常的严重程度相关。DNA分析可能是监测计划中选择高危患者进行筛查的一种有用的辅助工具。
