【摘要】 背景：近20年来食管和食管胃连接处（EGJ）腺癌发生率呈上升趋势，Barrett食管（BE）被认为是其发生的重要危险因素。目的：应用组织芯片技术研究Ki-67在各类食管胃黏膜病变中的表达及其与细胞增殖和凋亡的关系。方法：制作140例各类食管胃黏膜组织的组织芯片，结合免疫组化方法检测Ki-67和增殖细胞核抗原（PCNA）表达。以原位末端标记技术（TUNEL法）检测BE、食管腺癌和贲门癌的细胞凋亡情况。结果：BE、食管腺癌和贲门癌组Ki-67阳性率分别为40.9%、69.6%和61.9%，均显著高于正常贲门组织（0.0%, P<0.01）和贲门肠化生（IM）组（11.5%, P<0.05）。BE、贲门IM、胃窦IM、食管腺癌和贲门癌组PCNA阳性率均显著高于正常贲门组织（45.5%、42.3%、39.3%、52.2%和42.9%对10.0%, P<0.05）。BE、食管腺癌和贲门癌中Ki-67表达弱阳性和阳性者细胞凋亡指数均较表达阴性者显著降低（P<0.05），而PCNA仅表达阳性者凋亡指数较表达阴性者显著降低（P<0.05）。结论：BE和EGJ处肿瘤的发生与Ki-67表达异常有关，Ki-67较PCNA更能反映EGJ处细胞凋亡状态。更多还原

【Abstract】 Background: The incidence of esophageal and esophagogastric junction(EGJ) adenocarcinomas is increasing over the last two decades. Barrett’s esophagus(BE) is thought to be a premalignant condition of esophageal adenocarcinoma and most of adenocarcinomas at EGJ. Aims: To investigate the expression of Ki-67 in esophagogastric mucosal lesions and its relationship with cell proliferation and apoptosis by tissue microarray. Methods: Using tissue microarray technique, specimens of 140 various esophagogastric mucosal tissues were examined for Ki-67 and proliferating cell nuclear antigen(PCNA) expressions by immunohistochemical method. Cell apoptosis in BE as well as in esophageal and cardiac adenocarcinoma was determined by in situ end-labeling technique(TUNEL method). Results: The positivity rate of Ki-67 in BE, esophageal adenocarcinoma and cardiac adenocarcinoma was 40.9%, 69.6% and 61.9%, respectively,which was significantly higher than that in normal cardiac tissue(0.0%, P <0.01) and cardiac intestinal metaplasia(IM)tissue(11.5%, P<0.05). The positivity rate of PCNA in BE, cardiac IM, antral IM, esophageal adenocarcinoma and cardiac adenocarcinoma was 45.5%, 42.3%, 39.3%, 52.2% and 42.9%, respectively, which was significantly higher than that in normal cardiac tissue(10.0%, P<0.05). In BE, esophageal adenocarcinoma and cardiac adenocarcinoma, the cell apoptotic index in Ki-67 weakly positive and positive tissues was significantly lower than that in Ki-67 negative tissue(P <0.05);while the apoptotic index only in PCNA positive tissue was significantly lower than that in PCNA negative tissue(P<0.05).Conclusions: Abberant Ki-67 expression is involved in the development of BE and adenocarcinoma in EGJ. As compared with PCNA, Ki-67 is a more preferable marker reflecting apoptotic status in EGJ.更多还原