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目的：探讨大肠癌旁粘膜细胞增殖模式变化与肿瘤术后复发的关系。方法：用免疫组化染色方法对７８例大肠癌标本的癌组织、癌旁粘膜及１２例正常大肠粘膜进行ｐ５３蛋白、增殖细胞核抗原（ＰＣＮＡ）检测，并进行随访。结果：癌组织ＰＣＮＡ高表达明显高于癌旁（Ｐ＜００１），癌旁ＰＣＮＡ高表达与隐窝增殖区扩大、上移，明显影响术后第１年局部复发死亡率（Ｐ＜００１），癌组织ｐ５３蛋白阳性表达率６１５４％，癌旁为２６９２％，癌及癌旁ｐ５３阳性表达不影响细胞增殖活性及术后第一年内的复发死亡率（Ｐ＞００５）。结论：大肠癌的复发可能与大肠癌的发生一样是正常隐窝增殖分化失调的顺序过程。ＰＣＮＡ可直观表现其增殖活性及增殖模式。ｐ５３突变及表达是多中心性的，癌旁ｐ５３突变点的存在是肠癌局部复发的潜在因素。
Objective: To investigate the relationship between the change of proliferation pattern of adjacent mucosa cells and the recurrence of tumor after colorectal cancer. Methods: Immunohistochemical staining was used to detect p53 protein and proliferating cell nuclear antigen (PCNA) in 78 cases of colorectal cancer tissues, paraneoplastic mucosa and 12 cases of normal colorectal mucosa. RESULTS: The expression of PCNA was significantly higher in cancer tissues than in adjacent tissues (P<0.01). The high expression of PCNA and the enlargement and upshift of crypt proliferative regions adjacent to tumors significantly affected the local recurrence mortality rate in the first year after operation (P<0). 01), the positive expression rate of p53 protein in cancer tissue was 61. 54%, and paratumor was 26. 92%. The positive expression of p53 in cancer and adjacent tissues did not affect the cell proliferation activity and the relapse mortality rate in the first year after operation (P>0. 05). Conclusion: The recurrence of colorectal cancer may be the same as the occurrence of colorectal cancer. It is the sequential process of the imbalance of normal crypt proliferation and differentiation. PCNA can visually demonstrate its proliferative activity and proliferation pattern. The mutation and expression of p53 are polycentric, and the presence of paratumor p53 mutations is a potential factor for local recurrence of colorectal cancer.