Barrett食道和Barrett食道腺癌的临床病理学研究

A study of clinicopathology on Barrett's esophagus and Barrett's adenocarcinoma

本文报告Ｂａｒｒｅｔｔ食道４２例，其中８例具有腺癌结构。内镜观察：食道粘膜上皮粗糙、糜烂、颗粒状增生、斑块状隆起、溃疡、粘膜充血或苍白。组织学观察：Ｂａｒｒｅｔｔ食道上皮有三种不同形态，其中胃底型上皮８例，交界型上皮１４例，特殊型上皮２０例，８例具有腺癌结构，特殊型上皮与腺癌结构间可见过渡形态。粘液组化染色观察：２０例特殊型上皮，ＨＩＤ（＋）１８例，８例具有腺癌结构的病例，ＡＢ、ＨＩＤ均呈不同程度的阳性。ＡｇＮＯＲ染色观察，Ｂａｒｒｅｔｔ食道三种上皮与食道腺癌平均每核含ＡｇＮＯＲ颗粒数相比均有非常显著的统计学差异（Ｐ＜０．０１）；观察结果提示：Ｂａｒｒｅｔｔ食道与食道腺癌关系密切，特殊上皮型Ｂａｒｒｅｔｔ食道可能是食道腺癌的癌前病变。

cases of Barrett's esophagus (BE) in which 8 cases associated with adenocarcinomatous structure (BA) were reported. The esophagus epithelium was coarse, erosive, granular proliferative, spottily prominent,ulcerative, congestive or pale under endoscopic examination. The columnar epithelium in BE presented three different configurations, including 8 cases of gastric fundus-like epithelium, 14 cases of junctional epithelium and 20cases of specialized columnar epithelium in which 8 cases were BA. There were transitional structures between specialized columnar epithelium and adenocarcinoma. High iron diamin (HID) staining was positive in 18 of the 20 cases with specialized columnar epithelium and HID and AB were positive in different degree in the 8 cases with adenocarcinomatous structure in histochemical stains for mucin. The mean numbers of AgNOR granules were significantly different among the three types of epithelium in BE and BA in AgNOR staining (P<0. 01). The results suggested that BE be closely related to esophageal adenocarcinoma and the specialized columnar epithelium of BE be precancerous lesion of esophageal adenocarcinoma.