【作者】 赵焕；

【导师】 潘秦镜； 王明荣； 曹箭； 苏勤； 张询；

【作者基本信息】 中国协和医科大学 ， 病理学与病理生理学， 2009， 博士

【摘要】 背景与目的:食管癌细胞学诊断中常见到低度鳞状上皮内病变(LSIL)、非典型鳞状上皮细胞(ASC)或形态改变更轻微的细胞,这类细胞是否发生了癌变相关的分子改变尚不清楚。本研究旨在利用细胞形态学相结合的荧光原位杂交(FISH)技术检测LSIL/ASC细胞的染色体改变。方法:选择食管鳞癌手术切除组织癌肿表面刮取细胞标本67例及其癌旁粘膜表面细胞标本30例,经液基制片,进行巴氏染色后,采用8、10和11号染色体着丝粒探针,进行FISH检测,分析检测结果与临床病理参数之间的关系。结果:在癌肿表面细胞标本,癌细胞/可疑癌细胞(Ca.C/Suca.C)8、10和11号染色体表现非整倍体病例阳性率分别为98.4%、83.3%和96.1%,LSIL/ASC各为68.8%、55.6%和64.3%,Ca.C/Suca.C显著高于LSIL/ASC(P＜0.05)。在癌旁细胞标本,LSIL/ASC细胞中三条染色体非整倍体的阳性病例率分别为66.7%、46.2%和53.3%。癌肿表面与癌旁LSIL/ASC染色体异常无统计学差异(P＞0.05)。癌肿表面LSIL/ASC细胞中8、10号染色体同时畸变病例率与局部淋巴结转移及高临床分期正相关。所有标本中正常细胞均未见染色体畸变结论:食管脱落细胞液基薄片上可以建立与细胞形态相结合的FISH技术。食管鳞癌表面脱落的癌细胞及LSIL/ASC均可能发生8、10和11号染色体非整倍体改变,与细胞形态相结合的FISH技术可能辅助食管癌细胞学早期诊断。更多还原

【Abstract】 Objective:Low grade squamous intraepithelial lesion(LSIL),atypical squamous cell(ASC) or cells with slightly changes in morphology were often observed in cytological diagnosis.It remains unclear whether there occurred molecular changes related with carcinogenesis in these kinds of cells.In the present study,we explore the feasibility of fluorescence in situ hybridization(FISH) combined with cyto-morphology in the detection of chromosome aberrations in exfoliated cells from esophageal squamous carcinoma(ESCC).Methods:The specimens of liquid-based cytology were prepared by scraping from the surface of 67 tumor and 30 adjacent mucosa.After Pap staining,chromsome aberrations were detected with centromeric probes specific for chromosmes 8,10 and 11 by FISH.The correlations between these data and the clinicopathologic parameters were analysed.Results:The aneuploidy of chromosmes 8,10 and 11 were observed in cancerous and suspencious cancerous cells(Ca.C/Suca.C) of 98.4%,83.3%and 96.1%cases,and in LSIL/ASC of 68.8%,55.6%and 64.3%cases,respectively.The LSIL/ASC of 66.7%, 46.2%and 53.3%adjacent mucosa presented abnormality of the three chromosmes. There were siganificant higher aneuploidy rates in Ca.C/Suca.C than in LSIL/ASC(P＜0.05),but no statistic difference between LSIL/ASC exfoliated from the surface of tumor and from the adjacent mucosa.The simultaneous aberrations of chromosmes 8 and 10 were detected predominantly in LSIL/ASC from the surface of tumor with local lymph node metastasis and later clinical stages.No chromosome aberrations were found in all normal squmous epithelium.Conclusions:FISH technique combined with cytologic morphology could be established successfully in the specimens of liquid-based cytologic.The aberrations involving chromosomes 8,10 and 11 occurred in Ca.C/Suca.C and LSIL/ASC exfoliated from the suface of ESCC tissues.FISH combined with cytologic morphology could adjuncts to the cytological early diagnosis of ESCC更多还原