Ki67、CDX2在C型、D型和E型腺管开口肠上皮化生胃黏膜组织中的差异表达  

Differential expression of Ki67 and CDX2 proteins in intestinal metaplasia among gastric mucosa appearing as type C,D,or E pit pattern

作　　者：赵燕如[1] 赵治国[1] 马军[1] 黄煌[1] 刘超[1] 钟亚莉[1] 崔静[1] 李振峰[1] 任景丽[2] 吴会芳[2] 胡桂明[2] 

机构地区：[1]郑州大学第二附属医院消化内科,河南省郑州市450014 [2]郑州大学第二附属医院病理科,河南省郑州市450014

出　　处：《世界华人消化杂志》2012年第34期3310-3316,共7页World Chinese Journal of Digestology

摘　　要：目的:检测C型、D型和E型腺管开口肠上皮化生胃黏膜组织中Ki67、CDX2的表达情况,评估肠上皮化生程度(intestinal metaplasia,IM)与腺管开口形态的相关性.方法:应用免疫组织化学EnVision二步法检测Ki67、CDX2蛋白在452例不同腺管开口胃黏膜病变中的表达情况;苏木素-伊红染色法评估IM的程度.结果:在非萎缩性胃炎胃小凹腺管开口呈B型(B型腺管开口胃炎)、萎缩性胃炎伴IM胃小凹腺管开口呈C型(C型腺管IM)、萎缩性胃炎伴IM胃小凹腺管开口呈D型(D型腺管IM)、萎缩性胃炎伴IM胃小凹腺管开口呈E型(E型腺管IM)、低级别上皮内瘤变和胃窦腺癌组织中Ki67蛋白的表达阳性率分别为16.2%、40.5%、44.0%、64.3%、71.4%和87.1%,E型腺管IM组分别与C、D组之间差别有统计学意义(P=0.002,=0.008),而C与D组差异无统计学意义;以上6组中CDX2蛋白的表达阳性率分别为21.6%、75.0%、78.6%、81.0%、80.4%和84.3%,E型腺管IM组与C、D组之间没有统计学上的差异,但与B型腺管开口胃炎组的差异有统计学意义(P=0.000).IM程度E型>D型>C型,差异有统计学意义(P=0.000).结论:CDX2可能与胃黏膜IM组织的微形态无关;E型腺管IM黏膜比C型、D型的Ki67表达高,IM程度重,胃镜随访检查时应重视这些黏膜改变的活检.AIM： To detect the expression of Ki67 and CDX2 in intestinal metaplasia （IM） among gastric mu- cosa appearing as type C, D or E pit pattern, and to assess the correlation between the degree of IM and the morphology of gastric pits. METHODS： Immunohistochemistry was used to examine the expression of Ki67 and CDX2 proteins in 452 cases of gastric mucosal lesionswith different pit patterns. The degree of IM was evaluated by hematoxylin and eosin staining. RESULTS： The positive rates of Ki67 in non- atrophic gastritis （NAG） appearing as type B pit pattern （BG）, atrophic gastritis （AG） with IM appearing as type C pit pattern （CIM）, AG with IM appearing as type D pit pattern （DIM）, AG with IM appearing as type E pit pattern （EIM）, low intraepithelial neoplasia （LIN）, and gastric antrum adenocarcinoma （GAAC） were 16.2%, 40.5%, 44.0%, 64.3%, 71.4%, and 87.1%, respec- tively. The positive rate of Ki67 protein in EIM was significantly different from those in CIM and DIM （P = 0.002, 0.008）, but there was no difference between CIM and DIM. The positive rates of CDX2 protein were 21.6%, 75.0%, 78.6%, 81.0%, 80.4%, and 84.3% in the above groups, re- spectively. The positive rate of CDX2 protein in EIM was significantly different from that in BG （P=0.000）, but not different from those in CIM and DIM. The degree of IM was significantly higher in EIM than in DIM and CIM （P=0.000）. CONCLUSION： CDX2 may have no relationship with micromorphology of IM in gastric mucosa. The expression of Ki67 protein and the degree of IM in EIM were higher than those in CIM and DIM.

关 键 词：肠上皮化生 早期胃癌 腺管开口 窄带成像放大内镜 

分 类 号：R735.2[医药卫生—肿瘤]