Ki-67、COX-2在重度反流性食管炎和Barrett食管中的表达

The Clinical, Pathological Features and Expression of Ki-67 and COX-2 in Severe Reflux Esophagitis and Barrett's Esophagus

目的 研究重度反流性食管炎 (SRE)、Barrett食管 (BE)组织中 Ki- 6 7、COX- 2的表达及其意义。方法回顾性分析 15例 SRE和 2 5例 BE的临床表现、内镜特征、组织病理学 HE染色 ,并与正常食管组织对照 ,以 SP免疫组化法测定二者组织中 Ki- 6 7、COX- 2的表达。结果 SRE和 BE组 Ki- 6 7表达的阳性率和强度显著高于正常食管粘膜 (P<0 .0 1) ,且两组比较无统计学差异 (P>0 .0 5 ) ;COX- 2特异地表达于部分 BE上皮 ,在 SRE及正常食管上皮中不表达。结论 Ki- 6 7在 SRE和 BE的表达增强 ,其临床监测将有助于胃食管反流病 (GERD)患者的疗效随访和预后评价 ;COX- 2特异表达于 BE的上皮 ,提示 COX- 2选择性抑制剂在预防、治疗 BE,阻止其恶性发展方面具有潜在的临床意义。

Objective To study the clinical, pathological features of severe reflux esophagitis(SRE) and Barrett's esophagus (BE) and search for expression and significance of Ki-67 and COX-2 in their tissues. Methods Both SRE (n=15) and BE (n=25) cases were retrospectively analyzed for clinical manifestations, endoscopic findings and pathological features. The expression levels of Ki-67 and COX-2 of esopageal epithelium in the two groups were compared with that of normal esophageal(NE) epithelium (n=10) by immunoperoxidase staining. Results It was found that the positivity and staining intensity of Ki-67 expression in SRE and BE were higher than those in normal esophageal epithelium (P<0.01), but there were no statistical differences between these two groups (P>0.05); COX-2 was selectively expressed in some BE epithelium, but not in SRE and nomal esophageal epithelium. Conclusion There were intensified Ki-67 expressions in the epithelium of SRE and BE, which could help us to evaluate the prognosis of gastroesophageal reflux disease (GERD) patients clinically by surveillance of Ki-67. COX-2 was selectively expressed in BE epithelium, so COX-2 inhibitors may have the potential for treatment of BE and for chemoprevention of its malignant change.