【摘要】 目的 :探讨高、低发区人群贲门癌变过程中表皮生长因子受体 (EGFR)表达与病变发生发展的生物学意义。方法 :采用免疫组织化学方法 (ABC法 ) ,检测高 (133例 )、低发区 (14 2例 )居民贲门上皮不同程度病变的EGFR变化特征及其与病变的关系。结果 :在贲门癌高发区 ,随贲门上皮病变进展 ,慢性浅表性胃炎 (CSG)→慢性萎缩性胃炎 (CAG)→不典型增生 (DYS)→贲门腺癌 (GCA) ,EGFR蛋白阳性率分别为 4 3%、4 4 %、79%和 5 3% ;DYS组EGFR蛋白阳性率与其它各组比较差异有统计学意义 (P值均 <0 .0 5 ) ;EGFR蛋白表达阳性率随贲门癌分化程度降低而减低 ,但无统计学意义。在贲门癌低发区 ,随贲门上皮病变加重 ,EGFR蛋白阳性率呈明显上升趋势 ,从CSG→CAG→DYS→GCA ,EGFR蛋白阳性率分别为 16 %、2 7%、5 0 %和 4 6 % ;正常贲门组织 (NOR)、CSG与GCA ,NOR、CSG与DYS比较差异均有统计学意义 (P值均 <0 .0 5 )。EGFR蛋白表达阳性率不随贲门癌分化程度降低而改变。结论 :EGFR是贲门上皮癌变 ,特别是早期病变的重要分子变化。高、低发区贲门癌变可能存在不同的分子基础 ,环境中暴露的致癌因素不同 (质和量 )可能是导致这种差异的主要原因更多还原

【Abstract】 Aim: To determine the EGFR expression and its significant in gastriccardia carcinogenesis from the subjects at the high and low incidence areas for gastric cardia adnocarcinoma(GCA) on subjects at the high(133 cases) and low(142cases) incidence areas(LIA,HIA).Methods: Immunohistochemistry (ABC) method was undertaken to determine the expression of EGFR in gastriccardia carcinogenesis. Results: In the HIA, with the lesions progressed from CSG→CAG→DYS→GCA, the positive rates of EGFR expression were 43%, 44%, 79% and 53%, respectively; the difference was significant between DYS and other lesions ( P <0.05); from well and moderate to poorly differentiated groups, the positive rates of EGFR expression decreased, but the difference was not significant. With the lesions progressed from CSG→CAG→DYS→GCA, an increasing tendency of EGFR expression was observed in the LIA, and the positive rates were 16%, 27%, 50% and 46%, respectively; the difference was significant between NOR or CSG vs. GCA, NOR or CSG vs. DYS ( P <0.05); The positive rates of EGFR expression were similar in the different groups of differentiated GCA.Conclusions: EGFR may play an important role in gastric cardia carcinogenesis, especially in early stage. There may be some different mechanism in gastric cardia carcinogenesis at HIA and LIA. Different risk factors (quality and quantity) exposed in environment may be the reason for the difference.更多还原