Barrett食管粘蛋白表达及意义  

Mucin gene expression in Barrett's oesophagus

作　　者：赵晶京[1] 房殿春[1] 汪荣泉[1] 罗元辉[1] 章容[2] 徐承平[2] 于冬梅[2] 

机构地区：[1]重庆市第三军医大学西南医院全军消化病专科中心,4000038 [2]重庆市第三军医大学西南医院病理科

出　　处：《中华消化内镜杂志》2007年第6期434-437,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的检测 Barrett 食管中粘蛋白的表达,探讨粘蛋白表达的意义。方法采用免疫组化方法检测 Barrett 食管上皮中 MUC1、MUC2、MUC3、MUC5AC 及 MUC6粘蛋白的表达,分析粘蛋白表达与 Barrett 食管组织病理学分型及放大内镜下小凹分型问的关系。结果 Barrett 食管胃型化生上皮以及肠化上皮均可见 MUC1的弱阳性表达;肠化上皮中见 MUC2的强阳性表达,阳性表达主要位于杯状细胞胞浆中;MUC3不仅在 Barrett 食管肠化上皮表层的柱状细胞及杯状细胞浆表达,而且在肠化上皮的无肠化区的柱状细胞内也可见阳性表达;MUC5AC 不仅在 Barrett 食管胃、肠上皮化生的表层柱状上皮胞浆内强阳性表达,而且在杯状细胞亦见阳性表达;在 Barrett 食管胃、肠两型上皮化生的深层腺体均可见 MUC6的阳性表达,抗原定位于细胞浆内,杯状和柱状细胞均有阳性反应物质;在不同分型小凹中,绒毛状及不规则型小凹上皮 MUC2、MUC3的阳性表达显著高于点状和棒状(P<0.01);MUC2、MUC3仅在肠化上皮中表达,在胃底及交界型上皮中无表达;MUC1、MUC5AC 及 MUC6在胃型及肠型化生上皮中均呈阳性表达,阳性表达率在各组织病理分型间差异无统计学意义(P>0.05)。结论 Barrett 食管肠化生上皮中特异表达 MUC2与 MUC3;MUC3的表达可能是肠化形成的早期事件;绒毛状及不规则型小凹中 MUC2与 MUC3高表达提示两型小凹的肠型分化特点,检测其表达有助于 Barrett 食管特殊肠上皮化生的识别。Objective To assess mucin gene expression in Barrett＇s esophagus. Methods Mucin core protein-MUC1, MUC2, MUC3, MUCSAC and MUC6 were detected by immunohistochemistry. The relationship between mucin expression and magnification-endoscopic characteristics, pathohistologic epithelial types of Barrett＇s esophagus was analyzed. Results Mild expression of MUC1 was predominantly found in the superficial epithelium of both gastric and specialised intestinal metaplasia. In a small number of specimens, mild expression of MUC1 was also noted in glands. Strong MUC2 expression was noted only in the goblet cells in Barrett＇s oesophagus. MUC3 was expressed in the superficial columnar cells of specialized intestinal metaplasia with or without globlet cells but not in gastric metaplasia of the oesophagus. In some specimens MUC3 was expressed in the vacuolus of the globlet cells and the lumen of gland. Strong staining of MUCSAC was noted in the columnar epithelium of both gastric metaplasia and specialized intestinal metaplasia in Barrett＇s oesophagus, as well as expressed in the cytoplasm and vacuolus of the globlet cells in some specimens. Expression of MUC6 protein was detected at the basement of the crypts in gastric metaplasia and specialised Barrett＇s glands. Expression of MUC2 and MUC3 protein was found much higher in villous or irregular pit pattern than that in dot or rod pit pattern（P 〈 0. 01 ）. Conclusion The expression of MUC3 may prefigure the developing of Barrett＇s specialized IM. Villous or irregular pit pattern helps visually identify areas with IM. MUC2 and/or MUC3 expression may be useful in identifing the specialised intestinal metaplasia.

关 键 词：BARRETT食管 粘蛋白 

分 类 号：R571[医药卫生—消化系统]