Ki-67在Barrett食管、重度反流性食管炎和食管腺癌中的表达和意义

Expression of Ki-67 and its Significance in Barrett's Esophagus,Severe Reflux Esophagitis and Esophageal Adenocarcinoma

背景:Barrett食管是一种食管腺癌癌前病变。Ki-67是一种能较准确地评估细胞增殖状态的抗原,在肿瘤进程中可能起重要作用。目的:研究Ki-67在Barrett食管、重度反流性食管炎和食管腺癌中的表达和意义。方法:应用免疫组化SP法测定59例Barrett食管、5例重度反流性食管炎、5例食管腺癌和10例正常食管黏膜组织中Ki-67的表达。结果:Ki-67在重度反流性食管炎中的阳性率为80.0%,Barrett食管阳性率为76.3%,与正常食管黏膜组织(20.0%)相比有显著差异(P<0.05);食管腺癌阳性率为100%。Ki-67的表达随Barrett食管肠化生程度的加重而增高(P<0.05);而不同长度(短段、长段)、肠化生黏膜形态(全周型、舌型和岛型)以及不同程度(轻度、中度)异型增生的Barrett食管,Ki-67的表达均无显著差异(P>0.05)。结论:Ki-67在重度反流性食管炎和Barrett食管中表达增强,提示其在食管腺癌进程中起重要作用。

Background： Barrett＇s esophagus is a precancerous lesion of esophageal adenocarcinoma. Ki-67 is an antigen which can be used to estimate the process of cell proliferation and may play an important role in the course of development of cancer. Aims＂ To investigate the expression of Ki-67 and its significance in Barrett＇s esophagus, severe reflux esophagitis and esophageal adenocarcinoma. Methods： Expression of Ki-67 was determined in 59 cases of Barrett＇s esophagus, 5 severe reflux esophagitis, 5 esophageal adenocarcinoma, and 10 normal esophageal epithelium by immunohistochemical staining （SP method）. Results： Expression of Ki-67 was positive in 80.0% of severe reflux esophagitis and 76.3% of Barrett＇s esophagus, significantly higher than that in normal esophageal epithelium （20.0%, P〈0.05）. In esophageal adenocarcinoma, the expression of Ki-67 was positive in 100% of cases. The expression of Ki-67 increased with increase of the degree of intestinal metaplasia in Barrett＇s esophagus （P〈0.05）, however, its expression was not significantly different between different length （short-segment and long-segment）, types of Barrett＇s esophagus （circumferential, tongue and island types） and different degrees of dysplasia （low or moderate degree） （P〉0.05）. Conclusions： Expression of Ki-67 increases in severe reflux esophagitis and Barrett＇s esophagus, and may play an important role in the course of development of esophageal adenocarcinoma.