【摘要】 目的 :探讨河南食管癌高发区居民食管和贲门上皮癌变过程中C erbB2和c myc的表达变化特征及其与病变的关系。方法 :采用纤维内镜活检、组织病理学和免疫组织化学方法 ,对 84例无症状人群食管和贲门粘膜活检组织以及 30例食管鳞癌患者和 30例贲门腺癌患者的癌组织进行C erbB2和c myc的表达变化以及病理学的研究。结果 :5 8例食管粘膜活检组织中 ,共检出 16例正常食管上皮 ,34例基底细胞过度增生 (BCH)和 8例间变(DYS) ;2 6例贲门活检组织中 ,共检出 7例正常 ,6例慢性浅表性胃炎 (CSG) ,10例慢性萎缩性胃炎 (CAG)和 3例DYS。食管正常组织 ,BCH和DYS组织均未发现C erbB2阳性反应 ,但鳞状细胞癌 (SCC)组织C erbB2阳性率为5 0 % ;食管上皮各级病变组织均出现不同程度的c myc阳性反应 ,阳性率随病变进展而明显升高。贲门上皮各级病变组织均出现不同程度的C erbB2和c myc免疫阳性率均出现明显的升高 ,其中间变组织阳性率最高 ,而贲门癌组织中其阳性率略低于间变组织。结论 :c myc过度表达是食管和贲门癌变过程中频发的分子事件 ,并与病变进展密切相关。C erbB2过度表达与贲门上皮癌变密切相关 ,并可能是食管癌变晚期的重要分子事件更多还原

【Abstract】 Aim: To characterize the changes of C erbB2 and c myc expression in esophageal and gastric cardia multistage carcinogenesis and to correlate these changes with lesions progression.Methods: With mass survey, endoscopic biopsy, histopathology and immunohistochemistry methods, the study of expression of C erbB2 and c myc and their correlation with lesions’ progression was performed on 84 symptom free subjects and 30 patients with esophageal squamous cell carcinoma (SCC) and 30 cases with gastric cardia adenocarcinoma (GCA).Results: Among 58 esophageal biopsy samples, there were 16 cases with normal esophageal epithelia, 34 with basal cell hyperplasia (BCH), 8 with dysplasia (DYS). Of the 26 gastric cardia biopsy samples, there were 7 cases with normal gastric mucosa, 6 cases with chronic superficial gastritis (CSG), 10 cases with chronic atrophic gastritis (CAG), and 3 cases with DYS. There was no positive immunostaining for C erbB2 in normal esophageal epithelium, BCH and DYS. However, there were 50% of SCC tissues showing positive immunostaining for this protein. In contrast, all the esophageal lesions show different degree of positive staining for c myc, and the positive staining rate increased with the lesion progressed from normal to BCH and to DYS. In gastric cardia, the positive immunostaining for C erbB2 and c myc was observed in different degree of lesions, and the positive immunostaining rate increased with the lesion progression, highest in DYS, and a little lower in GCA.Conclusion: Overexpression of c myc is a frequent molecular event in esophageal and cardia carcinogenesis and closely correlated with progress of lesions. Overexpression of C erbB2 is associated with carcinogenesis of cardia epithelium closely, and may be an important molecular event in the late stage of esophageal carcinogenesis.更多还原