AgNOR定量检测对食管病变的诊断及预后的意义

DIAGNOSTIC AND PROGNOSTIC SIGNIFICANCE OF AgNOR QUANTITATIVE EXAMINATION IN ESOPHAGEAL LESIONS

本研究从胶质银技术对正常食管上皮、单纯增生、非典型增生、原位癌及浸润癌进行了核仁形成区嗜银蛋白（ＡｇＮＯＲ）定量研究，发现随病变进展，ＡｇＮＯＲ均值明显递增，各组间差异显著（Ｐ ＜０．０５、Ｐ＜０．００１）。在１３５例浸润癌中，ＡｇＮＯＲ与癌肿浸润深度、淋巴结转移密切相关（Ｐ＜０．０５，Ｐ ＜０．００１），而与其它临床病理指标无相关性存在。在随访的８９例浸润癌患者中，高ＡｇＮＯＲ均值（≥７）患者的５年生存率显著低于低均值（＜７）．患者（Ｐ＜０．００５）。因此，作者认为ＡｇＮＯＲ定量在鉴别食管癌及癌前病变、判定其生物学行为及预测患者预后中均有一定实用价值。

Using silver collid technique, AgNOR was investigated with quan- titative method in normal esophageal epithelium, simple hyperplasia, dysplasia, carcinoma in situ and invasive carcinoma. It showed that AgNOR increased obvioualy along with development of the lesions and a significant difference was found among various group (P< 0. 05, P< 0. 001). The AgNOR was closely associated with the penetrating depth and lymphnode metastasis of tumor.(P < 0. 05, P <0. 001) except other clinicopathological fac- tors in 135 cases with invasive carcinoma. The surotal rates of the patients with more AgNOR(≥7) was significantly poorer than those with less AgNOR(<7) in 89 patients with invasive carcinoma followed up five years(P<0. 005). Therefore, the authors conc- luded that AgNOR quantitation has certain practical value for differentiating esophageal carcinoma from precancerous lesions, judging its biological behaviour and predicting prognosis.