摘要
目的 从量化角度探讨大肠癌和腺瘤的病理结构特点及定量诊断问题。方法 外科手术切除的大肠腺癌30 例、腺瘤11 例、癌患者自身正常粘膜16 例。以大肠肠管长轴为纵轴在横、纵、水平三个相互垂直的方向上对以上三种组织取材和切片, 随机确定视野, 按照体视学原理随机测试以上三种组织, 根据有关体视学公式计算出体视学参数( Vvg 、Svg、Rsvg 、λg、Vvn 、Svn 、Rsvn、Rnp 、λ、v 、Nv 、Kv 、k 、s) , 比较这些参数在不同组织间的差异, 并进行逐步判别分析。结果 参数Vvn 、Svn 、Rnp、v、s、Vvg 的大小是依大肠正常组织、腺瘤、腺癌的排序而递增, Rsvn 、λ、Nv 、k 、Rsvg 的参数大小则依正常粘膜、腺瘤及癌排序方向而递减, 且三种组织间上述参数的比较差异均有显著性; 用判别分析筛选出诊断价值高的参数, 分别为Vvn 、Rnp 、Rsvg 、λ、V、Vvg, 并据此建立了诊断判别方程。结果表明三方向全取的取材方法诊断符合率略高于单方向取材方法。结论 本文对大肠癌组织和细胞体视学参数的定量分析结果, 进一步支持大肠癌发生、发展学说中的“腺瘤→癌”模式理论; 用三维体视学参数建立大肠癌、腺瘤及正常组织三者间的逐步判别函数, 有助于诊断的客观性和准确性的进一步提高, 三方向全取的取材方法能进一?
Objective To go further into the problem of quantitative diagnosis for colorectal carcinoma. Methods The mass specimens of 30 colorectal carcinomas, 11 colorectal adenomas and 16 normal colorectal mucosas were obtained from the underwent surgical resections. The three kinds of tissues were cut in three mutually vertical directions, namely: transversely, longitudinally and horizontally with the long axis of colorectal canal as the longitudinal axis. Measurements were made according to the stereological principles in the randomly chosen fields of the slices cut from the mass specimens in three different directions and the stereological parameters were acquired according to stereological formulae. The parameters were compared to analyze the differences among diffenent tissues and submitted to stepwise discriminant analysis, and a conclusion was drawn. Results Most of the stereological parameters showed a continuously processing variation with the heteromorphism of the glands and cells. The values of the stereological parameters of Vvn, Svn, Rnp, v, s and Vvg were gradually increased but those of Rsvn, λ, Nv, K and Rsvg were graually decreased in terms of the sequence of colorectal carcimome, ademoma and normal tissue. In addition, there were significant differences among the parameters in the three kinds of tissues. Several kinds of parameters (Vvn, Rnp, v, s and Vvg), which showed high diagnostic value, were chosen to establish diagnostic equations (discriminant functions). The accuracy of diagnosis by the discriminant function was higher with the method of sampling in three directions than that in only one direction. Conclusions The modle of occurrence and development that colorectal carcinoma occurs from adenoma to carcinoma is further supported by the stereological quantification analyses on the tissues and cells of colorectal carcinoma in our study. The objectivity and accuracy may be improved with the stepwise discriminant analysis of the three dimensional parameters in colorectal carcinoma, adenoma and normal tissue, and the methods of sampling in all of the three directions have higher value to enhance the effects of determination and diagnosis.
出处
《中国体视学与图像分析》
1999年第4期219-225,共7页
Chinese Journal of Stereology and Image Analysis
基金
国家自然科学基金
关键词
大肠癌
大肠腺癌
腺瘤
方向性
体视学
诊断
colorectal carcinoma colorectal adenoma direction stereology diagnosis
