IL-4和IFN-γ在反流性食管炎和Barrett食管活检黏膜中的表达及其与病理和内镜分级的关系

Expression of IL-4 and IFN-γ of the biopsy esophageal mucosa of patients with reflux esophagitis and Barrett esophagus and their relationship with pathological and endoscope grading

目的研究IL-4和IFN-γ在反流性食管炎(reflux esophagitis,RE)和Barrett食管(barrett′s esophagus,BE)活检黏膜中的表达及其与病理和内镜分级的关系。方法RE、BE患者和正常对照组各30例。记录RE患者内镜下表现以及RE和BE的病理表现。IL-4和IFN-γ在食管黏膜中的表达应用SABC法检测。结果IFN-γ在RE组(5.39±1.14)和BE组(5.94±1.79)表达的免疫组化评分均明显高于正常对照组(0.71±0.24)(P<0.001);IL-4在BE组(4.45±1.41)表达的免疫组化评分明显高于RE组(1.28±0.35)和正常对照组(0.80±0.20)(P<0.001);BE组病理损伤轻于RE组;RE组的IFN-γ表达分别与镜下分级(r=0.509,P<0.01)、病理分级(r=0.493,P<0.01)呈正相关。结论Th1/Th2免疫反应可能在RE和BE的发病机制中起到不同的作用,RE以Th1免疫反应为主,BE中则Th1、Th2免疫反应均起到重要作用。

Objective To investigate expression of IL-4 and IFN-γ of the biopsy esophageal mucosa of patients with reflux esophagitis （RE） and Barrett esophagus （BE） and their relationship with pathological and endoscope grading. Methods Thirty cases in RE, BE and the control group respectively were enrolled the test. To record the endoscopic and pathological features of patients with RE, and pathological features of patients with BE. The expression of IL-4 and IFN-γ of all specimens were detected by SABC of immunohistochemistry （IHC）. Results Expression of IFN-γ, was higher in BE （5.94 ± 1.79） or in RE （5. 39 ± 1.14） than in the control group （0. 71 ±0. 24） （P 〈0.01 ） ,and expression of IL-4 was higher in BE group （4. 45 ± 1.41 ） than in the RE group （ 1.28 ± 0. 35 ） or in the control （0. 80±0. 20） （ P 〈 0.01 ）. There was more serious pathological damage in the RE than in the BE group. There was a positive correlation between expression of IFN-γ and the endoscopic grading （r = 0. 509 ,P 〈 0.01 ） or the pathological grading （r =0. 493 ,P 〈 0. 01 ）. Conclusions Th1/Th2 immune response probably plays a different effect in the pathogenesis of RE and BE. The main effect on RE is Th1 immune response,but on BE is all of Th1 and Th2 immune responses.