杯状细胞在Barrett食管疾病进展中的作用  

Role of goblet cells in the progression of Barrett′s esophagus

作　　者：惠洋洋[1] 朱兰平 李变霞 王赛宇 杨波[1] 赵经文 张玉洁[2] 陈鑫[1] 王邦茂[1] Hui Yangyang;Zhu Lanping;Li Bianxia;Wang Saiyu;Yang Bo;Zhao Jingwen;Zhang Yujie;Chen Xin;Wang Bangmao(Department of Gastroenterology and Hepatology,Tianjin Medical University General Hospital,Tianjin 300052,China;Department of Pathology,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院消化科,300052 [2]天津医科大学总医院病理科,300052

出　　处：《中华消化杂志》2019年第11期731-734,共4页Chinese Journal of Digestion

基　　金：国家自然科学基金(81200261);天津市科技计划(15ZXJZSY00020);天津医科大学总医院青年孵育基金(2YYFY2016029);天津医科大学"十三五综投"研究生创新基金(YJSCX201901)。

摘　　要：目的探讨我国Barrett食管临床病理特征和杯状细胞数与Barrett食管异型增生严重程度的关系。方法回顾性分析2008年1月至2018年10月在天津医科大学总医院消化科接受胃镜检查发现并经病理确诊的453例Barrett食管患者的临床和病理资料,比较伴或不伴杯状细胞患者的临床病理特征;对伴杯状细胞的Barrett食管病理切片进行过碘酸希夫反应(PAS)染色,比较杯状细胞数、杯状细胞阳性隐窝数与Barrett食管异型增生的关系。统计学方法采用t检验和卡方检验。结果453例Barrett食管患者中,男251例(55.4%),女202例(44.6%)。伴杯状细胞的Barrett食管患者218例,男128例(58.7%),女90例(41.3%),发病年龄为(60.6±11.9)岁,发病年龄高峰为60~69岁;内镜下形态主要以全周型为主[58.2%(127/218)]。不伴杯状细胞的Barrett食管患者235例,男123例(52.3%),女112例(47.7%),发病年龄为(56.1±14.4)岁,发病年龄高峰为50~59岁;内镜下形态主要以全周型为主[40.0%(94/235)]。伴杯状细胞Barrett食管的异型增生发生率高于不伴杯状细胞的Barrett食管患者[75.7%(165/218)比37.0%(87/235)],差异有统计学意义(χ2=68.501,P<0.01)。PAS染色结果发现,杯状细胞可被染为紫红色,轻度异型增生的Barrett食管杯状细胞数、总隐窝数、杯状细胞阳性隐窝数、杯状细胞阳性隐窝比例均高于中度异型增生的Barrett食管患者[分别为95.50±40.56比40.00±13.34,21.00±8.31比11.83±2.92,16.50±6.17比7.50±2.47,0.79±0.42比0.63±0.12],差异均有统计学意义(t=-4.503、-3.605、-4.690、-4.340,P均<0.01)。结论Barrett食管异型增生可能与杯状细胞的出现有关,杯状细胞的减少或消失或许提示Barrett食管疾病的进展。Objective To investigate the clinical pathological features of Barrett′s esophagus in China,and to study the relationship between the number of goblet cells and the severity of Barrett′s esophageal dysplasia.Methods From January 2008 to October 2018,in the Department of Gastroenterology and Hepatology,Tianjin Medical University General Hospital,the clinical and pathological data of 453 patients who underwent gastroscopy and pathologically diagnosed with Barrett′s esophagus were retrospectively analyzed.The clinical pathological features were compared between patients with goblet cells and patients without goblet cells.Periodic acid Schiff reaction(PAS)staining was performed on pathological slides of Barrett′s esophagus with goblet cells,and the relationship between the number of goblet cells,the number of positive crypts of goblet cells and the severity of Barrett′s esophageal dysplasia was analyzed.T test and chi-square test were performed for statistical analysis.Results Among 453 patients with Barrett′s esophagus,251(55.4%)were males and 202(44.6%)were females.There were 218 Barrett′s esophagus with goblet cells,including 128 males(58.7%)and 90 females(41.3%).The average onset age was(60.6±11.9)years old,and the peak onset age was between 60 and 69 years old.The appearance under endoscopy mainly was circumferential type(58.2%,127/218).There were 235 Barrett′s esophagus without goblet cells,123 males(52.3%)and 112 females(47.7%).The average onset age was(56.1±14.4)years old,and the peak onset age was between 50 and 59 years old.The appearance under endoscopy was mainly circumferential type(40.0%,94/235).The incidence of dysplasia in Barrett′s esophagus with goblet cells was higher than that without goblet cells(75.7%,165/218 vs.37.0%,87/235),and the difference was statistically significant(χ2=68.501,P<0.01).PAS staining showed that goblet cells were stained purplish red.The number of goblet cells,total number of crypts,the number of positive crypts of goblet cells and the proportion of posi

关 键 词：BARRETT食管 杯状细胞 异型增生 食管腺癌 

分 类 号：R57[医药卫生—消化系统]