贲门癌癌旁肠上皮化生类型与贲门癌发生部位关系  

Correlation of intestinal metaplasia adjacent to gastric cardia adenocarcinoma (GCA) and the occurrence site of GCA in high incidence area in Henan

作　　者：温巍[1] 丁广成[1,2] 王立东[1] 王能超[1] 范宗民[1] 陈志国[3] 任景丽[1,4] 李吉林 伍玥[1] 宋昕[1] 秦豫培[1] 周丽[1] 

机构地区：[1]河南省食管癌重点开放实验室、郑州大学第一附属医院、郑州大学基础医学院,郑州450052 [2]郑州大学第五附属医院放疗科,郑州450052 [3]新乡医学院癌症研究中心,新乡453003 [4]郑州大学第二附属医院病理科,郑州450052 [5]河南省林州市姚村食管癌医院病理科,林州456592

出　　处：《临床与实验病理学杂志》2009年第2期140-142,146,共4页Chinese Journal of Clinical and Experimental Pathology

基　　金：国家自然科学基金(30670956);河南省医学科技攻关项目(20058)

摘　　要：目的探讨河南贲门癌高发区贲门癌(GCA)发生部位与癌旁肠上皮化生(IM)的组织学和组织化学特征之间的关系。方法根据肿瘤与齿状线的关系,将770例贲门癌分成6种类型:A型:肿瘤全部位于齿状线下方;B型:肿瘤2/3位于齿状线下方;C型:肿瘤1/2位于齿状线下方;D型:肿瘤1/3位于齿状线下方;E型:肿瘤全部位于齿状线上方;F型:齿状线完全被肿瘤侵犯,难以区分肿瘤与齿状线的关系。采用阿利新兰-雪夫试剂染色法和高铁二胺-阿利新兰染色法研究295例GCA癌旁IM的组织学和组织化学特征。分析GCA发生部位与癌旁IM关系。结果GCA以A型和B型为主(94%),高于C型和D型(P<0.05),未检出E型和F型。GCA癌旁IM的检出率为39%(115/295),完全性结肠型所占比例39%(45/115),高于另外3型(χ2=36.765,P<0.05)。A、B、C三型GCA癌旁IM检出率差异无统计学意义(χ2=3.500,P>0.05)。A、B型GCA癌旁IM均以完全型为主(χ2=81.203,P<0.05;χ2=34.154,P<0.05),这两种不同部位GCA癌旁IM亚型分布无差异(χ2=4.174,P>0.05)。结论河南贲门癌高发区GCA癌旁IM以完全型为主,但与贲门癌发生部位无关,而与胃远端癌及西方Barrett食管的IM不同。Purpose To correlate the occurrence site of gastric cardia adenocarcinoma （GCA） and the histological and histochemical patterns of intestinal metaplasia （IM） adjacent to GCA in high incidence area in Henan. Methods Based on the relationship between location of GCA and Z-line, 770 cases with GCA were classified into six types, i.e. , type A ： total of the tumor located below Z-line; type B：2/3 of the tumor located under Z-line; type C： half of the tumor located under Z-line; type D：1/3 of the tumor located under Z-line;type E： total of the tumor located above Z-line; type F： total of the Z-line was invaded by tumor and could not make a clear classification based on Z-line. Histological and histochemical patterns of 295 cases with IM adjacent to GCA were determined using histochemical staining methods （ AB-PAS and HID-AB）. The correlation between the occurrence site of GCA and IM adjacent to GCA was analyzed. Results Types A and B were predominant （94%）, which were higher than type C and D （ P 〈 0. 05 ）. Types E and F were not observed in this study. The detection rate of IM adjacent to GCA was 39% （115/295）. The rates of complete colonic type IM were 39% （45/115）, which occurred more frequently than other three types （χ^2 =36. 765 ,P 〈0.05）. The differences among the rates of IM adjacent to types A, B and C were not significant （χ^2 = 3. 500,P 〉 0. 05 ）. Complete type IM adjacent to types A and B was predominant （χ^2 = 81. 203 ,P 〈 0. 05;χ^2 = 34. 154,P 〈 0.05）. The distribution of subtype IM adjacent to types A and B was similar （χ^2 = 4. 174 ,P 〉 0.05 ）. Conclusions The histological and histochemical patterns of IM adjacent to GCA in high incidence area in Henan are quite different from that adjacent to stomach cancer and Barrett＇ s esophagus, but are similar in different site of GCA.

关 键 词：贲门癌 肠上皮化生 发生部位 组织化学 

分 类 号：R735.2[医药卫生—肿瘤]