目的:评估非Lynch结肠腺癌的DNA倍体和S期分数(SPF),溃疡性结肠炎(UC),克罗恩病(CD)被称为危险因素,和结肠炎。我们将倍性和SPF与肿瘤分级相关联,分期和BRAF表达。
方法:所有研究的腺癌都有完整的错配修复基因,免疫组织化学证明。通过自动基于图像的DNA细胞术评估所有的倍性并绘制直方图。通过抗BRAFV600E进行免疫染色。进行诊断性腹腔镜检查(DL)是对GI癌症进行分期的初步步骤。
结果:组间DNA倍性存在显著差异;非整倍体病例中有77.5%和17.5%是腺癌和UC。各组以2C进行比较,4C,4C以上的DNA含量和SPF和显著差异主要在腺癌组和其他人之间发现。在腺癌中,DNA倍性与肿瘤分期和分级显著相关。关于BRAF表达式,组间有显著差异;所有腺癌,83.33%的UC为阳性,而所有的结肠炎病例,胆汁性结肠炎,CD为阴性。在包括腺癌在内的所有二倍体病例中,BRAF和SPF之间存在显着关系,在非肿瘤性二倍体病例中。BRAF强度与腺癌分期有直接的显著关系。UC病例之间的BRAF和倍性之间没有显着差异,尽管75%的非整倍体UC为阳性。DL有助于GI癌症分期。开腹手术前常规腹腔镜检查,尤其是在可操作性不明确的癌症中,有助于避免不必要的开腹手术。
结论:基于腺癌和UC之间以及SPF和倍性之间的倍性差异,因此,通过DNA细胞计数评估UC和其他结肠炎的倍性可以预测结肠发育不良发生之前即将发生的恶性转化.测量腺癌中的SPF也有助于选择可能从化疗中受益的患者。DL在GI癌症分期中具有至关重要的作用。
OBJECTIVE: To evaluate DNA ploidy and S-phase fraction (SPF) in non-Lynch colonic adenocarcinoma, ulcerative colitis (UC), Crohn disease (CD) which are known as risk factors, and colitis. We correlated ploidy and SPF with tumor grading, staging and BRAF expression.
METHODS: All studied adenocarcinomas have intact mismatch repair genes as proved by immunohistochemistry. All were assessed for ploidy by automated image-based DNA cytometry and histograms were drawn. Immunostaining by anti-BRAF V600E was performed. Diagnostic laparoscopy (DL) was done as a preliminary step for staging GI cancers.
RESULTS: there is significant difference in DNA ploidy between groups; 77.5% and 17.5% of aneuploid cases are adenocarcinoma and UC. Groups are compared in terms of 2C, 4C, above 4C DNA content and SPF and significant difference is principally found between adenocarcinoma group and others. In adenocarcinomas, DNA ploidy is significantly correlated with tumor staging and grading. Regarding BRAF expression, there is significant difference between groups; all adenocarcinomas, 83.33% of UC were positive, while all cases of colitis, bilharzial colitis, CD were negative. There is significant relation between BRAF and SPF among all diploid cases including adenocarcinoma, and among non-neoplastic diploid cases. There is direct significant relation between BRAF intensity and adenocarcinoma staging. There is no significant difference between BRAF and ploidy among UC cases, although 75% of aneuploid UC are positive. DL helps in GI cancer staging. Routine laparoscopy before laparotomy, especially in cancers which have equivocal operability helps to avoid unnecessary laparotomies.
CONCLUSIONS: Based on significant difference in ploidy between adenocarcinoma and UC and between SPF and ploidy, assessment of ploidy by DNA cytometry for UC and other colitis could therefore predict impending malignant transformation before development of colonic dysplasia. Also measuring SPF in adenocarcinoma helps to select patients who could greatly benefit from chemotherapy. DL has vital role in staging GI cancers.