胃上皮异型增生在印戒细胞癌发生中的作用  

Role of gastric epithelial dysplasia in the pathogenesis of signet-ring cell carcinoma

作　　者：周志华[1] 赵海滨[1] 张建东[2] 赵玲娜[1] 单宝珍[1] 

机构地区：[1]解放军第101医院病理科,江苏省无锡市214044 [2]解放军第101医院医务处,江苏省无锡市214044

出　　处：《实用医学杂志》2009年第22期3791-3795,共5页The Journal of Practical Medicine

摘　　要：目的:探讨上皮异型增生在胃印戒细胞癌发生中的作用。方法:以42例早期胃印戒细胞癌为研究材料,AB-PAS(奥辛蓝-过碘酸雪夫)染色观察印戒细胞和癌旁异型增生所含黏液的组织化学特性;免疫组化染色检测两者表达胃和肠上皮标志物MUC5AC,MUC6,MUC2,CD10的情况,并将印戒细胞和异型增生分为G型(胃型)、GI型(胃肠型)、I型(肠型)和U型(未分化型)四类,统计并比较印戒细胞、癌旁异型增生的类型。以20例早期肠型胃癌作为对照。结果:AB-PAS染色显示,印戒细胞所含的黏液主要为中性及混合性黏液,癌旁异型增生上皮分泌的黏液成分与印戒细胞一致;免疫组织化学染色显示,印戒细胞的分类以G型为主,癌旁异型增生G型更多见,而I型少见;G型、GI型异型增生可向印戒细胞癌移行,且在GI型异型增生移行为印戒细胞癌时,肠上皮标志物的表达逐渐下降。结论:印戒细胞癌的发生与上皮异型增生有关,而伴有胃型上皮分化的异型增生可能是印戒细胞癌的癌前病变。Objective To investigate the role of gastric epithelial dysplasia（GED） in the pathogenesis of gastric signet-ring cell carcinoma（SRCC）.Methods 42 cases of early gastric SRCC were involved in this study.Mucins secreted by signet-ring cells and GED adjacent to carcinoma were analyzed by AB-PAS（Alcian blue-periodic acid schiff） staining.The expressions of gastric or intestinal epithelial markers,such as MUC5AC,MUC6,MUC2,and CD10 in singnet-ring cells and GED were detected by immunohistochemical staining.All lesions were classified as G type（gastric type）,GI type（gastrintestinal type）,I type（intestinal type）,and U type（undifferentiated type） according to the markers expressed.Then the types of GED and signet-ring cells were differentiated.Additionally,20 cases of early intestinal-type gastric carcinoma were employed as control.Results AB-PAS staining showed that signet-ring cells contained neutral or mixed mucin,which were similar to GED.Most of the signet-ring cells and GED were G type,and I type was rare in GED.Furthermore,both G type and GI type GED could transform to signet-ring cells.And the expressions of intestinal epithelium markers were gradually declined when GI type GED progressed to SRCC.Conclusion The pathogenesis of SRCC is associated with GED,and GED with gastric epithelium differentiation may be the precursor lesion of gastric SRCC.

关 键 词：胃肿瘤 印戒细胞癌 异型增生 肿瘤发生 免疫组织化学 

分 类 号：R735.2[医药卫生—肿瘤] R730.231[医药卫生—临床医学]