碘染色联合p53、Survivin及端粒酶检测对早期食管癌及癌前病变的诊断价值  

The role of endoscopy iodine staining combined detecting the expression of p53, survivin and telomerase in the diagnosis of early esophageal carcinoma and precancerous lesions

作　　者：刘春安[1] 张新东[2] 杨艳[1] 马凯[1] 白景芝[1] 王祥阁[2] 王静[1] 柴同海[1] 

机构地区：[1]山东省滕州市中心人民医院消化内科,山东滕州277500 [2]山东省滕州市中心人民医院病理科,山东滕州277500

出　　处：《中国医师杂志》2009年第4期447-450,共4页Journal of Chinese Physician

基　　金：山东省枣庄市培养学科带头人专项资金资助项目（2006407）

摘　　要：目的探讨内镜下碘染色联合组织p53、Survivin及端粒酶检测对早期食管癌及癌前病变的诊断价值。方法本院因上消化道症状接受胃镜检查且食管黏膜有可疑病变的门诊及住院患者300例进行卢戈碘液染色。对直径≥5mm的不染区或淡染区取活检送病理。用免疫组化方法对病理组织学检查证实为黏膜不典型增生、早期食管癌及30例正常对照者分别检测p53、Survivin及端粒酶表达情况。结果碘染色对食管黏膜不典型增生轻、中、重度及早期鳞状细胞癌检出率分别为16．3％、9．7％、3．7％和4．3％。不典型增生及早癌组织中p53蛋白、Survivin及端粒酶表达相关性有统计学意义，并且碘不染色与p53、Survivin及端粒酶阳性表达相关性也有统计学意义（P均〈0．01）；碘染色联合p53、Survivin及端粒酶检测对重度不典型增生和早期食管癌诊断的敏感性、特异性和准确率分别达100％、92．3％和91．8％。结论碘染色联合p53、Survivin及端粒酶检测对诊断早期食管癌及其癌前病变具有重要价值。Objective To study the value of using endoscopy iodine staining combined detecting the expression of p53, survivin and telomerase in the diagnosis of early esophageal carcinoma and precancerous lesions. Methods Three hundred patients who received routine gastroscopy and had high risk of esophageal carcinoma were examined by the iodine dyeing on their esophageal mucosa with 2. 5% Lugol solution. Multiple biopsies were taken from the unstained or light-stained areas when their diameters were over 5mm for pathology diagnosis. The expression of p53, survivin and telomerase were detected by immunohistochemical staining. Results With the Lugol staining method, the incidences of light, moderate and high grade dysplasia and early esophageal carcinoma were 16. 3% ,9.7% ,3.7% and 4. 3% respectively. The expression of p53, survivin and telomerase were related and the unstained were related to the expression of p53, survivin and telomerase in dysplasia and early esophageal carcinoma. Using endoscopy iodine staining combined testing p53, survivin and telomerase showed sensitivity of 100%, specificity of 92. 3% and accuracy of 91.8% to diagnose of early esophageal carcinoma and high grade dysplasia. Conclusion Lugol solution chromoendscopy combined assay of p53, survivin and telomerase might be useful in the diagnosing early esophageal carcinoma and precancerous lesion.

关 键 词：碘化合物/诊断应用 染色与标记 基因 P53 微管相关蛋白质类 端粒 末端转移酶 食管肿瘤/诊断 

分 类 号：R735.1[医药卫生—肿瘤]