食管粘膜活检对食管癌前病变诊断的重复性研究  

Studies on the reproducibility of esophageal precancerous lesion detection by biopsy sampling procedure

作　　者：王立东[1] 周琦[1] 张兰[1] 郭仁勇 邢莹[1] 张保才[1] 李启驹[1] 张联[1] 裘宋良[1] 

机构地区：[1]河南医科大学医学实验中心癌症研究室,河南省肿瘤病理学重点实验室,焦作市第二人民医院,南阳地区卫校,新乡医学院生理学教研室,新乡市中心医院,北京医科大学

出　　处：《河南医科大学学报》1995年第2期112-116,共5页Journal of Henan Medical University

基　　金：国家自然科学基金;美国NCI联合资助

摘　　要：为评价食管粘膜上皮活检取样对食管癌前病变检出的重复性的影响，对来自河南食管癌高发区２８例患者行食管内镜检查和中、下段粘膜活检组织学病理检查，１０ｄ后对同一人群作重复检查。组织病理学分析显示，第二次粘膜活检组织中，食管中段２４％的患者病变减轻，２８％的患者病变加重，４８％的患者病变维持不变。食管下段粘膜活检中，４８％的患者病变减轻，１６％的患者病变加重，３２％的患者病变维持不变。结果提示，粘膜活检取样误差是造成以往报道人群癌前病变随访中出现病变“逆转”或“进展”的一个因素。肿瘤抑制基因Ｐ５３蛋白聚集的重复性检出率较高，可能是食管癌变过程中的有效生物学观察指标。The main objective of this study is to evaluate the biopsy sampling procedure in the detection of esophageal precancerous lesions. Biopsies were taken from the middle-third and the lower-third of the esophagus of 28 subjects from a high incidence area of esophageal cancer in Henan, China, The sampling procedure was repeated on the same subjects 10 days later. During this period, all subjects followed their usual dietary habits. Histopathological analysis showed that in the second sampling from the middle-third of the esophagus, 24% of the subjects had less severe lesions, 28% had more severe lesions and 48% had the same severity of lesions. In those from the lower-third of the esophagus, 48% of the subjects had less severe lesions, 16% had more severe lesions and 32% had the same severity of lesions. The results suggest that the reproducibility of biopsy procedure may be a factor for the previously reported“reversion”or“progression”of precancerous lesions in follow-up studies. High reproducibility of P53 protein immunostaining indicates that P53 seems to be a promising biomarker in esophageal carcinogenesis.

关 键 词：癌前病变 食管肿瘤 活体组织检查 诊断 食管粘膜 

分 类 号：R735.104[医药卫生—肿瘤]