Barrett食管组织中COX-2和Bcl-2的表达与癌变风险  

Expressions of COX-2 and Bcl-2 in Barrett's esophagus and probability of esophageal adenocarcinoma occurrence

作　　者：向明确[1] 谢文义[1] 袁晓英[1] 王志宁[1] 王旭东[1] 李智泉[1] 陈诗奉[1] 

机构地区：[1]重庆市第九人民医院消化科,重庆400700

出　　处：《第四军医大学学报》2008年第19期1807-1810,共4页Journal of the Fourth Military Medical University

基　　金：重庆市北碚区科委资助项目(重庆碚科委[2005]35号)

摘　　要：目的:研究COX-2和Bcl-2在Barrett食管(BE)相关病变组织中的表达意义.方法:胃镜下采用Lugol液染色,活检获得实验标本,HE染色观察病理特征.用SP免疫组织化学方法检测正常食管上皮10例、中重度反流性食管炎23例、BE45例和食管腺癌14例组织中COX-2和Bcl-2的表达,进行半定量分析,并预测BE的癌变风险.结果:COX-2在正常食管上皮、中重度反流性食管炎、BE、食管腺癌组织中的表达呈逐渐增强趋势.BE和食管腺癌组织中呈强阳性表达,表达率接近100%,且两种组织的表达强度无明显差异(P=0.334).Bcl-2的表达变化与COX-2基本一致.COX-2在全周型的表达明显强于舌型和岛型两种形态的BE,但差异无统计学意义(P>0.05).LSBE黏膜中COX-2的表达明显强于SSBE;重度肠化时COX-2的表达显著强于无肠化和中低度肠化组织,差异有统计学意义(P<0.05).低度、高度异型性增生的BE黏膜COX-2均呈高表达,尤其在后者的组织中最强,两者间差异显著.LSBE,重度肠化生及高度异型增生BE组织中的表达与腺癌差异无统计学意义(P>0.05).而腺癌与其余各类型BE的表达差异均有统计学意义(P<0.05).Bcl-2在不同类型BE及腺癌组织中的表达差异与COX-2基本一致.结论:BE与腺癌中Bcl-2与COX-2的表达最强,不同程度肠化生时,Bcl-2的表达变化无显著差异.AIM： To study the expressions and significance of COX-2 and Bcl-2 in all kinds of Barrett＇s esophagus and analyze probability of incidence of adenocarcinoma in patients with Barrett＇s esophagus （BE）. METHODS ： We stained esophageal epithelium by Lugol liquid under endoscope and took experimental specimen by biopsy, and observeed pathological characteristics by HE staining. The expressions of COX-2 and Bel-2 were detected and semi-quantified by SP immunohistochemical techniques in medium/severe reflux esophagitis （ RE, n = 23 ）, BE （ n = 45 ）, esophageal ad （ EAC ,n = 14） ,and normal esophageal epithelium（n = 10） to predict cancerization risk. RESULTS ： The expression of COX-2 in normal esophageal epithelium, medium/ severe RE, BE and EAC tissues was increased gradually. And the expression in BE and EAC was quite strong, positive rate approaching 100%, and the expression between the two tissues had no significant difference （ P = 0. 334 ）. Expression of Bcl-2 was almost consistent with COX-2. The expression of COX-2 in looposhaped BE was stronger than that in tongue-shaped or islandshaped BE, while the expression difference had no statistical significance（P 〉0.05）. COX-2 expression in mucous membrane of long-segment BE（LSBE） was stronger than that in short-segment BE（SSBE）, the difference being significant. COX-2 expression in high degree intestinal metaplasia was significantly higher than that in non-intestinal metaplasia or medium/low degree one. COX-2 displayed high expression in BE with low grade and high- grade dysplasia, especially the latter, and both had significant difference. The expression in LSBE, BE tissue with high degree intestinal metaplasia or high-grade dysplasia was not statistically significantly different from that in EAC. While the expression in EAC was significantly different from that in other kinds of BE. Bcl-2 expression in different BE and EAC was consistent with COX-2. CONCLUSION： Expressions of Bcl-2 and COX-2 in BE and EAC are the most

关 键 词：Barrett's食管 环氧化物酶2 基因 BCL-2 

分 类 号：R735.2[医药卫生—肿瘤] R616.4[医药卫生—临床医学]