肝肠钙粘连蛋白在反流性食管炎、Barrett食管和食管腺癌中的表达及意义  

Expression of Liver-Intestine cadherin in reflux esophagitis、Barrett esophagus, and esophageal adenocarcinoma

作　　者：史丽芳[1] 苏秉忠[1] 李艳梅[1] SHI Li-fang;SU Bing-zhong;LI Yan-mei(Digestive department of the Affiliated Hospital of Inner Mongolia Medical University,Hohhot Inner Mongolia 010050)

机构地区：[1]内蒙古医科大学附属医院消化内科,010050

出　　处：《现代消化及介入诊疗》2018年第1期1-5,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：内蒙古自治区自然科学基金(2013MS1190)

摘　　要：目的研究肝肠钙粘连蛋白(LI-cadherin)在反流性食管炎(RE)、Barrett食管(BE)、食管腺癌(EA)、胃黏膜肠化生(GIM)中的表达,探讨BE和EA早期诊断的分子学标志物及BE伴肠化生(简称BE2)与GIM的关系。方法选取2013年8月至2014年12月就诊于内蒙古医学院附属医院,经胃镜或手术取得标本,组织学证实为RE、BE不伴有肠化生(简称BE1)、BE2、BE伴不典型增生(简称BE3)、EA患者各30例,选取同期GIM及正常人各20例为对照组。用免疫组织化学SP法、酶联免疫吸附法(ELISA)分别对入选者的组织、血清中的LI-cadherin进行检测,对获得的结果进行统计学分析。结果 LI-cadherin在组织、血清中检测显示:正常食管黏膜中不表达,在RE、BE1、BE2、BE3中的表达逐渐升高,而在EA低表达,在GIM表达为55.00%。在组织中,BE2、BE3组中的表达高于正常组、RE组、BE1组及EA组,差异均有统计学意义。BE1与GIM组中的表达差异有统计学意义。在血清中,BE1、BE2、BE3组中的表达高于正常组、RE组、EA组,在BE2、BE3组中的表达高于BE1组,差异均有统计学意义。在BE1组与GIM组中的表达差异有统计学意义。Spearman相关性分析,LI-cadherin血清中含量与组织中表达存在正相关关系。LI-cadherin在TNM分期Ⅲ+Ⅳ期的表达低于Ⅰ+Ⅱ期,差异有统计学意义。结论 (1)LI-cadherin为早期筛查BE及EA提供分子学诊断依据;(2)BE伴肠上皮化生为EA的癌前病变;(3)LI-cadherin表达与EA的TNM分期有关;(4)患者血清中LI-cadherin的含量可以反映其组织中的水平。Objective To investigate the relationship among reflux esopgagitis(RE)、Barrett esophagus(BE)and Esophageal Adenocarcinoma(EA),the expression of liver-intestine cadherin(LI-cadherin)was studied.While explore it association with the clinicopathologic characteristics of the patients.To reserch the expression of LI-cadherin in BE and gastric intestinal metaplasia(GIM).Methods Esophogeal mucosal specimens were obtained by endoscopical biopsy or surgery.Using immunohistochemistry and enzyme-linked immunosorbent assay(ELISA),expression of LI-cadherin was analyzed in serum and tissues of RE,BE without IM(BE1),BE with IM(BE2),BE with dysplasia(BE3)and EA(n=30 in each group),as well as in normal esophageal mucosa(NEM,n=20)and GIM(n=20).Results In both tissues and serum,expression of LI-cadherin was increased gradually with the progressive transformation from NEM to RE,BE1,BE2,BE3,but low in EA,and high in GIM(55.00%).The differences were statistically significant(P<0.05).The expression of LI-cadherin in serum showed a positive correlation to that in tissues.LI-cadherin expression was significantly(P<0.05)correlated with TNM classification of EA.Conclusions LI-cadherin could be a valuable marker for early dectection of EA;BE with IM is a precancerous condition of EA;LI-cadherin expression may be correlated with TNM classification of EA;the expression levels of LI-cadherin in serum can reflect their expression levels in tissues.

关 键 词：肝肠钙粘连蛋白 BARRETT食管 食管腺癌 

分 类 号：R571[医药卫生—消化系统]