Laparoscopic surgery and adjuvant chemotherapy based on DNA analysis using fluorescence in situ hybridization in fresh human gastrointestinal tumors

应用荧光原位杂交(FISH)技术对59例胃癌标本进行染色体和p53基因突变的检测，并探讨其临床应用价值。结果如下：1.利用荧光原位杂交技术可以检测到胃活检组织中染色体数目的异常，而正常组织和癌旁正常组织中的单体和多倍体比例无显著差异。2.正常组织和肿瘤组织中1、7、11和3号染色体的单体比例差异有统计学意义(均大于3个拷贝/细胞)。3.在31例手术标本中，7号、11号和17号染色体多倍体肿瘤的淋巴转移和淋巴导管侵袭的发生率显著高于对照组。…的发生率显著高于对照组。17号染色体多倍体肿瘤静脉侵袭较多，1号和11号染色体异倍体肿瘤腹膜播散发生率高，提示染色体特异性数量异常可能参与了胃癌的发生发展。4.应用双色荧光原位杂交技术检测20例早期胃癌组织，发现sm侵袭的胃癌组织中p53表达降低的细胞比例明显高于正常组织。更重要的是，在有sm侵袭的淋巴结阳性的胃癌中，p5 3缺失的比例显著增加。提示早期胃癌的淋巴结转移可能与p53基因缺失有关。5.基于上述结果，胃活检标本的双色FISH分析是一种有效的方法，可以在术前预测癌前病变的恶性潜能，对有m和sm侵袭的胃癌，特别是对淋巴结转移有预测作用。较少

The efficacy of fluorescence in situ hybridization (FISH) in alteration of chromosome and p53 gene was evaluated as an potential malignant marker and its clinical application in 59 gastric cancer specimens. The results are the followings :1.Numerical chromosome aberrations in gastric biopsy specimens could be detected with FISH.There was no significant difference concerning the fraction of monosomy and polysomy between normal and adjacent normal tissues in gastric tumor specimens.2.There was a significant difference concerning the fraction of monosomy in chromosome 1,7,11 and 3 polysomy (more than 3 copies per cell) in chromosome 1,7,11,17 between normal and tumor tissues. These results indicate that chromosome numerical aberrations may involve in tumorgenesis and its development.3.Regarding 31 surgical specimens, the significant high incidences of lymphnode metastasis and lymphoductal invasion were observed in polyploid tumors in chromosome 7,11 and 17. The significant high incidence … More of venous invasion was observed in polyploid tumors in chromosome 17. The significant high incidence of peritoneal dissemination was observed in aneuploid tumors in chromosome 1 and 11. These results suggest that the specific numerical aberrations of chromosomes may involve in invation and development of gastric tumors.4.Using dual-color fluorescence in situ hybridization 20 early gastric cancers, a significant increase of the fraction of p53 decreased cells was observed in gastric cencer with sm invasion than that of normal tissues. More importantly, a signofocant increase of the fraction pf p53 deletion was observed in lymphnode positive gastric cancers with sm invasion. This finding suggests that lymphnode metastasis may be associated with the deletion of p53 gene in early gastric cancer.5.Based on these results, dual-color FISH analysis with gastric biopsy specimens seems effective method which could predict malignent potential of premalignant lesion, and that of gastric cancers with m and sm invasion before operation, especially concerning lymphnode metastasis. Less