糜烂性食管炎、Barrett食管及食管腺癌中SOX2、CDX2的表达及其临床意义  

SOX2,CDX2 expressions in Barrett's esophagus,erosive esophagitis,esophageal adenocarcinoma

作　　者：许良璧[1] 项一宁[2] 杨浩羿[1] 肖源[1] 张伟光[1] 刘亚琳[1] 

机构地区：[1]贵州医科大学附属医院消化内镜中心,贵阳550001 [2]贵州医科大学附属医院病理科,贵阳550001

出　　处：《临床与实验病理学杂志》2016年第9期1014-1018,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：贵州省科技厅社发攻关项目[黔科合SY(字)(2013)3009号]

摘　　要：目的探讨CDX2、SOX2在糜烂性食管炎、Barrett食管的3种不同组织类型(胃底型、贲门型、肠化生型)及食管腺癌(esophageal adenocarcinoma,EAC)中的表达及意义。方法采用免疫组化Eli Vision两步法检测CDX2和SOX2在35例贲门组、23例胃底组、14例肠化组、10例糜烂性食管炎组、7例EAC组、10例正常食管下段黏膜中的表达情况。结果 CDX2在肠化组及EAC组中的阳性率均为85.7%,显著高于其他四组(P<0.05);CDX2阳性率在贲门组(11.4%)、胃底组(0)、糜烂性食管炎组(0)及正常食管组(0)中的差异无显著性(P>0.05)。CDX2在贲门组(75%)及EAC组(66.7%)以(+)为主,差异无统计学意义(P>0.05),与肠化组(91.7%)以()为主显著不同(P<0.05)。SOX2在Barrett食管三组中的阳性率均为100%,显著高于EAC组(28.6%)(P<0.05)。SOX2以(++)表达方式在胃底组(95.7%)及贲门组(74.3%)中差异无统计学意义(P>0.05);显著高于肠化组(50%)和EAC组(50%)(P<0.05)。SOX2和CDX2的表达在肠化型Barrett食管中呈负相关(P<0.05),在贲门组、胃底组、EAC组中无明显相关(P>0.05)。结论短段贲门型Barrett食管中CDX2的阳性率不高,可能只是一种柱状上皮化生,与EAC的关系不大;CDX2在鳞状上皮向特殊肠上皮化生转化过程中发挥重要作用,SOX2的沉默促进EAC发生。Purpose To investigate the immunohistochemical expression of CDX2, SOX2 in Barrett＇ s esophagus （BE） （fundic-type, cardiac-type, intestinal-metaplasia）, erosive esophagitis （EE）, esophageal adenocarcinoma （EAC）. Methods Expression of CDX2 and SOX2 was determined by EliVision two-step immunohistochemical method in 72 patients BE [ including cardiac-type BE （ n = 35 ） , fundic-type BE （n = 23）, intestinal-metaplasia （goblet cell） - type BE （n = 14） ], 10 EEs, 7 EACs, and 10 normal esophagus. Re- suits The expression level of CDX2 in intestinal metaplasia-type BE （ 85.7% ） and EAC （ 85.7% ） was higher than that in fundic- type BE （11.4%）, cardiac-type BE （0）, EE （0）, and normal esophagus （0） （P 〈0.05）. There was no significant difference in cardiac-type BE （75%） and EAC （66. 7% ） which displayed focal expression CDX2 （P 〉 0. 05 ）. The percentage of intestinal-posi- tive （91.7%） specimens with diffuse distribution of CDX2 expression was higher than in cardiac-type BE （25%） and EAC （33.3%） （P 〈 0. 05 ）. The expression of SOX2 significantly increased in 3 different types BE （ 100% ） than in EAC （ 28. 6% ） （ P 〈 0.05 ）, but there was no significant difference in 3 different type BE （P 〉 0. 05 ）. There was no significant difference in fundic-type （95.7 % ） and cardiac-type BE （74. 3% ） cases which displayed diffuse expression SOX2 （P 〉 0. 05 ）, higher than intestinal- type BE （50%） and EAC （50%） specimens （P 〈 0. 05 ）. SOX2 expression was negatively correlated with CDX2 in intestinal metaplasia-type BE （ P 〈 0. 05 ）. However, SOX2 expression was not correlated with CDX2 in fundic-type BE, cardiac-type BE and EAC （P 〉 0.05 ）. Conclu- sion The low positive rate of CDX2 in the short segment of cardiac-type BE may suggest it is only columnar-lined esophagus （CLE） with little relationship to EAC. The CDX2 may play an important role of the transformation of the squamous

关 键 词：食管肿瘤 食管腺癌 BARRETT食管 尾型同源盒转录因子2 性别决定区Y框蛋白2 免疫组织化学 

分 类 号：R735.1[医药卫生—肿瘤]