短段Barrett’s食管的不同组织类型、内镜形态、异型程度与Cyclin D1、P53表达的相关性研究  

Correlation between the expression of Cyclin D1 and P53 protein in different pathological classification,endoscopic morphology and organization atypia of short segment Barrett's esophagus

作　　者：王炘[1] 王雯 詹志刚[1] WANG Kin;WANG Wen;ZHAN Zhigang(Department of Gastroenterology,the 92nd Hospital of PLA,Nanping 353000;Fuzong Clinical Medical College,Fujian Medical University,China)

机构地区：[1]中国人民解放军第92医院消化内科,福建南平353000 [2]福建医科大学福总临床医学院

出　　处：《胃肠病学和肝病学杂志》2018年第6期649-652,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的研究细胞周期蛋白D1(Cyclin D1)、P53蛋白在短段Barrett’s食管(short segment Barrett’s esophagus,SSBE)不同组织类型、不同内镜形态、不同异型程度分组中的表达,预测不同类型SSBE上皮癌变的风险性,准确筛选高危人群,为指导制定内镜随访计划提供依据。方法选取经电子胃镜、病理检查确诊为SSBE的患者51例,另取32例正常食管黏膜组织作为对照。再根据SSBE不同内镜下形态分为全周型16例、舌型13例、岛型22例,根据不同病理组织类型分为胃底型20例、贲门型21例、特殊肠化型10例,根据BE组织异型增生的程度分为无异型增生组37例、轻度异型增生组14例、重度异型增生组0例。采用免疫组化法检测不同亚组细胞Cyclin D1和P53蛋白的表达,并进行统计学分析。结果 Cyclin D1、P53在SSBE组及正常食管黏膜组中的表达均较低,差异无统计学意义(P>0.05)。Cyclin D1、P53在SSBE不同内镜下形态分型、不同组织学分型各亚组中的表达差异均无统计学意义(P>0.05)。Cyclin D1、P53在合并异型增生组中均表达升高,Cyclin D1在无异型增生、轻度异型增生组中的表达阳性率分别为21.6%、64.3%,组间差异有统计学意义(P=0.007);P53在无异型增生、轻度异型增生组中的表达阳性率分别为27.0%、71.4%,组间差异有统计学意义(P=0.006)。结论 SSBE总体癌变风险低。SSBE的癌变风险与内镜形态分型及组织学分型的不同无直接相关性。对合并异型增生者,Cyclin D1和P53的表达明显升高,提示SSBE伴异型增生者癌变风险明显增加。Objective To investigate the expression of Cyclin D1 and P53 protein in different pathological classification,endoscopic morphology and organization atypia of short segment Barrett＇s esophagus（ SSBE）,predict the risk of canceration in patients with SSBE,screen the patients with high-risk accurately,and provide an evidence for making endoscopic follow-up plan. Methods Fifty-one cases with SSBE were diagnosed by endoscopy,biopsy and pathological examination. Another 32 cases with normal esophageal mucosa were chosen as the control group. According to endoscopic morphology,the cases with SSBE were sub-grouped included circumferential type（ 16 cases）,tonguedlike type（ 13 cases） and island type（ 22 cases）. According to histopathology,the cases with SSBE were classified to gastric fundus type（ 20 cases）,cardia type（ 21 cases） and special intestinal metaplasia type（ 10 cases）. According to organization atypia,the cases with SSBE were included non-dysplasia（ 37 cases）,low-grade dysplasia（ 14 cases） and high-grade dysplasia（ no case）. The expressions of Cyclin D1 and P53 protein were examined with the SP immunohistochemistry method and the results were statistically analyzed. Results The expressions of Cyclin D1 and P53 protein in SSBE group and normal esophageal mucosa had no statistically significant difference（ P 0. 05）. No remarkable differences about the expressions of Cyclin D1 and P53 protein among the subgroups according to endoscopic morphology and histopathology were found（ P 0. 05）. The expressions of Cyclin D1 and P53 protein were all in high level in SSBE group with dysplasia. The positive rates of Cyclin D1 in non-dysplasia group,low-grade dysplasia group were 21. 6%,64. 3%,respectively,the difference between two groups was statistically significant（ P = 0. 007）. The positive rates of P53 protein in non-dysplasia group,low-grade dysplasia group were 27. 0%,71. 4%,respectively,there was significant difference between two groups（ P = 0. 006）. Conclusion

关 键 词：短段Barrett’s食管 组织异型性 细胞周期蛋白D1 P53蛋白 免疫组织化学 

分 类 号：R571[医药卫生—消化系统]