内镜下大肠黏膜微细结构改变中BRCA1蛋白的表达及临床意义  

Clinical significance of expression of BRCA1 protein in microstructural changes of colorectal mucosa observed by magnifying chromoendoscope

作　　者：唐采白[1] 程惠敏[2] 刘晓林[1] 张世强[3] 赵俊华[1] 王恒[1] 刘敏[1] 

机构地区：[1]徐州医学院第三附属医院消化科,江苏徐州221003 [2]徐州医学院第三附属医院病理科,江苏徐州221003 [3]徐州医学院第二附属医院肿瘤科,江苏徐州221006

出　　处：《南京医科大学学报（自然科学版）》2011年第8期1224-1226,1234,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏徐州市科技计划基金资助项目(XM08C067)

摘　　要：目的:通过检测BRCA1蛋白在大肠黏膜微细结构改变中的表达,探讨BRCA1蛋白在不同大肠黏膜病变腺管开口分型中表达的临床意义。方法:根据Kudo分型方法,染色放大内镜下大肠黏膜病变腺管开口分为Ⅰ～Ⅴ型;其中Ⅰ～Ⅱ型为非肿瘤性病变,ⅢL～Ⅳ型为腺瘤,Ⅴ型为癌性病变,所有病变诊断结果均由病理学证实。应用免疫组化方法检测活检组织BRCA1蛋白的表达。结果:染色放大内镜下检出Ⅰ～Ⅴ型息肉样病变256枚,其中非肿瘤性病变(73例),肿瘤性病变(183例);随着大肠腺管分型序数的递增,BRCA1蛋白的阳性表达率逐渐增加,各腺管分型之间的差异具有统计学意义(P<0.000 1);癌性病变BRCA1蛋白的阳性率明显高于腺瘤性病变和非肿瘤性病变(P<0.000 1)。结论:随着大肠腺管分型序数的递增,BRCA1蛋白的阳性率逐渐增加,尤其在内镜诊断的大肠癌性病变中有着较高的表达率。因此,染色放大内镜下观察大肠黏膜微细结构改变的同时联合检测BRCA1蛋白的表达有助于大肠癌的早期发现。Objective：To detect expression of BRCA1 in colorectal polypiod lesions,and find its clinical significance in different pit patterns.Methods：According to Kudo criteria,pit patterns observed by magnifying chromoendoscopy include I ～V type,nonneoplastic lesion（Ⅰ～Ⅱtype）,adenomas lesion（ⅢL～Ⅳ type） and cancer lesion（Ⅴtype）.All samples diagnosises were proved by pathological examination.Biopsy specimens were used to detect expression of BRCA1 proteins by SP immunohistochemical method.Results：Total 256 polypoid lesions were observed by magnifying chromoendoscopy.The positive expressions of BRCA1 increased gradually from type Ⅰ to type Ⅴ,and there were statistical significances between every two groups（P 〈 0.000 1）;The positive expresion of BRCA1 protein in cancer lesions was significantly higher than that in adenomas lesions and nonneoplastic lesions（P 〈 0.000 1）.Conclusion：The positive rate of BRCA1 protein expression gradually increased in different pit patterns,especially in cancer lesions diagnosed by magnifying chromoendoscope.It was helpful to find early colorectal cancer by the detection of the BRCA1 protein expression in colorectal lesions combined with magnifying chromoendoscope.

关 键 词：大肠肿瘤 BRCA1蛋白 免疫组织化学 腺管开口 染色放大内镜 

分 类 号：R735.34[医药卫生—肿瘤]