胃癌癌旁肠化上皮酶组织化学研究

本文应用酶组化方法对６０例胃癌癌旁粘膜中４７例肠化上皮（７８．３％）的破性磷酸酶（ＡＬＰ）、酸性磷酸酶（ＡＣＰ）、胞嘧啶单核苷酸酶（ＣＭＰ）、葡萄糖－６－磷酸酶（Ｇ－６－ｐａｓｅ）、焦磷酸硫胺素酶（ＴＰＰａｓｅ）、５－核苷酸酶（ＳＮａｓｅ）、三磷酸腺苷酶（Ｍｇ２＋－ＡＴＰａｓｅ，Ｃａ２＋－ＡＴＰａｓｅ）和细胞色素氧化酶（ＣＣＯ）等九种细胞器标志酶进行了定位观察。结果发现肠化上皮吸收细胞上述酶活性均较强，且分布具有极性，杯状细胞酶反应较弱，主要位于细胞基底部。癌旁粘膜肠化阳性率为７８．３％，其中ＡＬＰ阳性的酶完全型肠化和ＡＬＰ阴性的酶不完全型肠化分别占５３．２％，４６．８％，两者出现率相近。酶完全型肠化ＡＬＰ阳性率在胃分化型癌及未分化型癌瘤旁分别占６９．２％和３３．３％。ＡＬＰ阳性率在胃分化型及未分化型癌组织内分别为３５．５％和０％。提示肠化上皮具有与肠上皮相似的代谢特征，酶完全型肠化和酶不完全型肠化可能是肠化的二种不同的形式，在致癌环境下，二者都有可能转变成癌，其中酶完全型肠化与分化型癌的关系较为密切。

A ENZYMATTC HISTOCHEMICAL STUDY ON INTESTINAL METAPLASIA SURROUNDING STOMACH CARCINOMAS

Localization of alkaline phosphatase,acid phosphatase,cytidine-5'-monophosphatase,glucose-6-phosphatase,thiamine pgrophosphatase,5'-nucleolidase,Mg-ATPase,Ca-ATPase and CCO of 47 intestinal metaplasia(IM) in 60 cases of tissues surrounding stomach carcinotnas were studied with enzytnatic histochemical technique.The result showed absorptive cells of IM had stronger enzymatic activities and retained polar distribution.The enzymatic reactions of goblet cells were weaker and localized in the hasal part of the cells.The rate of iM tissues surrounding stomach carcinomas was 78.3%,in which of ALP positive enzymatic complete iM and ALP negative enzymatic incomplete iM were 53.2% and 46.8% respectively.The ALP positive rate of complete IM cases in tissues surrounding differentiated and undifferentiated carcinomas were 69.2% and 33.3% (P<0.05),while the ALP positive percentage in both types of carcinoma tissues were 35.5% and 0% (P<0.01) respectively.It is considerated suggests that the epithelium of IM in stomach mucosa have the similar function to that of intestine.Enzymatic complete and incomplete IM cases might be two different forms of IM,and under carcinogenic condition,both of them can change into carcinoma,in which enzymatic complete IM is interrelated to differentiated carcinoma.