| Objective: To study the expression of P21 and P53 in the mucosa adjacent to the rectal cancer, and the distance of mucosa adjacent to the rectal cancer. To discuss the relationship of the expression of P21 and P53 between the rectal cancer tissue and the mucosa adjacent to the cancer, and discuss the affection of the mucosa adjacent to the cancer that which distance is safe for the distal edge in rectal cancer dissection. Method: To examine the expression of P21 and P53 in the body of the rectal cancer and the mucosa adjacent to the cancer, and the relationship between the expression and the change of mucin. The immunohistochemical research help finish the study, and the samples came from the 34 patients who had got dissection for rectal cancer. Result: 1. It were 9 samples who had had distal diffused, the ratio is 29.4%, the distance of the distal diffusion were all inner 2 cm, in them, 7 inner 1cm, and 3 inner 2cm but beyond 1cm.2. All 34 samples of tumor body had the same manifestation, they showed the mucosa adjacent to cancer, and they had continuity from the tumor body. In all samples I had studied, the distance of mucosa adjacent to cancer were all inner 4cm.3. The range of positive P53 in TM adjacent to the cancer was inner 4cm of distal rectum cavity, and they were all weak positive expression in 3-4cm cavity of distal rectum; the range of positive P21 was inner 2cm of distal rectum cavity; the mucosa who expressed positive P21 and P53 were all transitionally changed mucosa, the P21 and P53 were all negative in the contrastive mucosa. 4. There were 20 samples who got P53 positive in the tumor body, positive rate is 58.6%; and the number of P53 positive in the tissue of the cancer was 10, it is 29.3%. It had no difference between them from data analysis.5. There were 21 samples who got P21 positive in the tumor body, positive rate is 61.5%; and the number of P21 positive in the tissue of the cancer was 9, it is 26.4%. It had no difference between them from data analysis.Conclusion:1. In recently, the anus-reserved dissection for rectal cancer has rapidly developed, one of the brief theoretical basis is that the distance of distal diffused of rectal cancer is not 5cm that people thought before. Now, internal doctors consider that 3cm is enough distance from tumor to distal in rectal cancer, and it is 2cm even 1cm by external doctor,s theory. The result of my study can also confirm this theory, the pathology of the samples showed that it was inner 2cm of distal diffused.2. It is transitional mucosa adjacent to carcinoma that lied in the place that is between the normal mucosa and the mucosa of colorectal cancer, it is a piece of transmitted mucosa, its histochemical trait is that the content of saliva acid mucin in the caliciform cells increased, and the content of vitriol mucin decreased or disappeared, but the histoexamination had any uncommon, these mucosa ia called transitional mucosa adjacent to the cancer(TM). TM came from the histochemical trait of mucosa adjacent to cancer, that is the change of mucin. The molecularbiology research about TM presented that TM is a piece of transmitted mucosa that is between tumor and normal mucosa. The presentation include the immature epithelial cells,increased mid-stage cells, the thicker mucosa, gland tube stretched and hemorrhage, and it has many branches, the amount of caliciform cells increased, the volume extended, the mucus prosperously secreted. In this tissue, there had no cancer cells and mass, in HID-AB stain, it presented beyond degree II saliva acid mucosity protein reaction.3. In our specimens ,the distance of mucosa adjcent to cancer are less 4cm .Some researchs indicate that the range of mucosa migration of proximal and distal of cancer is far separated.It is hard to describe it by a mean.They vary from 0 to 19.5cm ,by a mean of 3.4cm .Also some data is 0.3 to 9.6cm.The variation does not seem to relate to length of TM ,mass ,stage of Dukes , differentiation etc. the possible reason why our results is not m...
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