食管癌前病变与食管腺癌细胞DNA倍体变化分析

Precancerous Lesion of Esophagus and Analysis on Ploidy Changes for Cell DNA of Esophageal Adenocarcinoma

目的探讨慢性炎症-癌前病变-食管腺癌不同阶段的食管黏膜细胞DNA含量及倍体变化,从细胞代谢水平揭示食管癌的发展过程.方法用流式细胞术对15例检查未见器质性病变者的正常组织,27例胃食管反流病患者(GERD)、25例Barrett食管患者和31例食管腺癌患者的病变组织细胞DNA含量进行了检测,并对四组的DNA倍体类型、DNA指数(DI)、G2/G1、增殖活性(SPF)和细胞增殖活性指数(PI)做了对比分析.结果食管腺癌22例DNA含量全部为非整倍体变化(DNA指数DI>1.1),Barrett食管25例中仅6例为非整倍体DNA含量,胃食管反流病和健康者无1例为非整倍体DNA含量;食管腺癌组G2/G1、SPF、PI较正常组织和胃食管反流病组均有明显升高(P<0.05),Barrett食管组介于胃食管反流病与食管腺癌之间,并且G2/G1、SPF和PI指标差异均有统计学意义(P<0.05).流式细胞术诊断阳性率差异显著.结论食管癌的发展是一个渐进的过程,各阶段之间密切相关.

Objective To investigate the esophageal nuclear DNA content and ploidy changes of chronic inflammation-precancerous lesion-esophageal adenocarcinoma at different stages,and reveal that the development of esophageal cancer is a progressive process from view of cell metabolism. Methods For 15 patients without evidence of organic lesions in normal tissue,27 cases with gastroesophageal reflux（GERD）, 25 cases with Barrett and 31 cases with esophageal adenocarcinoma, flow cytometry was used to test cell DNA content, and for DNA ploidy, DNA index（DI）, G2/G1 , proliferative activity（SPF） and proliferation index（PI）of four groups,comparative analysis was done. Results For 22 cases with esophageal adenocarcinoma, all aneuploid changes happened on DNA content （DNA index DI〉1. 1）. But for Barrett esophagus, only six of 25 cases had aneuploid DNA content. In the end, for gastroesophageal reflux disease and healthy objects,no aneuploid DNA content happened. Compared with that of normal tissue and gastroesophageal reflux disease groups, index of G2/G1, SPF, PI for esophageal adenocarcinoma group were significantly higher（ P 〈0.05） ;while the index of Barrett esophagus group were between that of gastroesophageal reflux disease esophageal adenocarcinoma groups,G2/G1 ,SPF and PI indices were significant different, P 〈0. 05; flow cytometry diagnostic produced significant differences. Conclusion Esophageal cancer development is a progressive process,and there is a strong correlation between the various stages.