【摘要】 目的:研究COX-2和Bcl-2在Barrett食管(BE)相关病变组织中的表达意义.方法:胃镜下采用Lugol液染色,活检获得实验标本,HE染色观察病理特征.用SP免疫组织化学方法检测正常食管上皮10例、中重度反流性食管炎23例、BE45例和食管腺癌14例组织中COX-2和Bcl-2的表达,进行半定量分析,并预测BE的癌变风险.结果:COX-2在正常食管上皮、中重度反流性食管炎、BE、食管腺癌组织中的表达呈逐渐增强趋势.BE和食管腺癌组织中呈强阳性表达,表达率接近100%,且两种组织的表达强度无明显差异(P=0.334).Bcl-2的表达变化与COX-2基本一致.COX-2在全周型的表达明显强于舌型和岛型两种形态的BE,但差异无统计学意义(P>0.05).LSBE黏膜中COX-2的表达明显强于SSBE;重度肠化时COX-2的表达显著强于无肠化和中低度肠化组织,差异有统计学意义(P<0.05).低度、高度异型性增生的BE黏膜COX-2均呈高表达,尤其在后者的组织中最强,两者间差异显著.LSBE,重度肠化生及高度异型增生BE组织中的表达与腺癌差异无统计学意义(P>0.05).而腺癌与其余各类型BE的表达差异均有统计学意义(P<0.05).Bcl-2在不同类型BE及腺癌组织中的表达差异与COX-2基本一致.结论:BE与腺癌中Bcl-2与COX-2的表达最强,不同程度肠化生时,Bcl-2的表达变化无显著差异.更多还原

【Abstract】 AIM:To study the expressions and significance of COX-2 and Bcl-2 in all kinds of Barrett’s esophagus and analyze probability of incidence of adenocarcinoma in patients with Barrett’s esophagus(BE).METHODS:We stained esophageal epithelium by Lugol liquid under endoscope and took experimental specimen by biopsy,and observeed pathological characteristics by HE staining.The expressions of COX-2 and Bcl-2 were detected and semi-quantified by SP immunohistochemical techniques in medium/severe reflux esophagitis(RE,n=23),BE(n=45),esophageal adenocarcinoma(EAC,n=14),and normal esophageal epithelium(n=10)to predict cancerization risk.RESULTS:The expression of COX-2 in normal esophageal epithelium,medium/severe RE,BE and EAC tissues was increased gradually.And the expression in BE and EAC was quite strong,positive rate approaching 100%,and the expression between the two tissues had no significant difference(P=0.334).Expression of Bcl-2 was almost consistent with COX-2.The expression of COX-2 in loop-shaped BE was stronger than that in tongue-shaped or island-shaped BE,while the expression difference had no statistical significance(P>0.05).COX-2 expression in mucous membrane of long-segment BE(LSBE)was stronger than that in short-segment BE(SSBE),the difference being significant.COX-2 expression in high degree intestinal metaplasia was significantly higher than that in non-intestinal metaplasia or medium/low degree one.COX-2 displayed high expression in BE with low grade and high-grade dysplasia,especially the latter,and both had significant difference.The expression in LSBE,BE tissue with high degree intestinal metaplasia or high-grade dysplasia was not statistically significantly different from that in EAC.While the expression in EAC was significantly different from that in other kinds of BE.Bcl-2 expression in different BE and EAC was consistent with COX-2.CONCLUSION:Expressions of Bcl-2 and COX-2 in BE and EAC are the most outstanding,while there is no significant difference between the two tissues.Expressions of Bcl-2 and COX-2 are the strongest in EAC,LSBE,high degree intestinal metaplasia and high-grade dysplasia tissue.The expressions are not significantly different between loop-shaped BE and tongue-shaped or island-shaped BE,and between different-degree intestinal metaplasias.更多还原