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目的研究直肠癌癌旁黏膜p21、p53蛋白的表达,探讨对直肠癌切缘距离的临床意义。方法应用免疫组化方法检测34例直肠癌癌旁移性黏膜中p21、p53蛋白表达。结果①直肠癌远端扩散有9例,占29.4%,远端扩散距离均在2cm以内;②34例直肠癌标本其癌组织远端均表现为癌旁黏膜,其癌旁黏膜的距离均未超过4cm;③P53蛋白在癌组织中表达阳性为20例,阳性率为58.6%;在癌旁表达为10例,阳性率为29.3%。同时资料表明两者之间无显著性差异;④P21蛋白在癌组织中表达阳性为21例,阳性率为61.5%;在癌旁组织表达为9例,阳性率为26.4%。同时资料表明两者之间无显著性差异。结论直肠癌远端肠管移性黏膜2～4cm处于癌前病变状态,建议远端切除距离应更长些。
Objective To study the expression of p21 and p53 proteins in the para-cancerous mucosa of rectal cancer and to explore the clinical significance of the resection margins of rectal cancer. Methods Immunohistochemistry was used to detect the expression of p21 and p53 protein in 34 cases of rectal mucosa adjacent to cancer. Results ① There were 9 cases (29.4%) of distant metastasis of distal rectal cancer and 2 cm of distal spread. (2) The distal mucosa of 34 cases of rectal cancer showed no adjacent mucosa, 4cm; ③P53 protein expression in cancer tissue was 20 cases, the positive rate was 58.6%; adjacent to the expression of 10 cases, the positive rate was 29.3%. At the same time the data showed no significant difference between the two; ④ P21 protein expression in cancer was positive in 21 cases, the positive rate was 61.5%; adjacent tissue expression was 9 cases, the positive rate was 26.4%. At the same time the data show that there is no significant difference between the two. Conclusion The distal colorectal mucosa of rectal cancer 2 ~ 4cm in precancerous lesions, it is recommended that the distal resection distance should be longer.