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Barrett食管的形态学、免疫组织化学及hTERC基因表达 被引量:2

Morphology, immunohistochemistry and hTERC gene in-situ hybridization in Barrett's esophagus
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摘要 目的探讨Barrett食管(BE)活检标本的临床病理学特点及与近端胃肠化黏膜的鉴别诊断。方法按WHO标准选取BE标本38例,观察病理组织学特征,对38例BE、44例近端胃肠化黏膜进行免疫组织化学CK7、CK20、CK4、CK8、SLOOP、MUC6、COX2、bc1-2观察,并用荧光原位杂交(FISH)方法检测hTERC基因情况。结果BE和近端胃肠化黏膜中CK7、CK20、MUC6、COX2、bc1-2表达差异无统计学意义(P〉0.05)。SLOOP阳性表达在BE与近端胃肠化黏膜间差异有统计学意义(P〈0.05);BE中CK7与CK4、CK7与CK8表达结果呈正相关(P〈0.05)。近端胃肠化黏膜中CK7与CK4、CK7与CK8表达结果均无相关性(P〉0.05);使用FISH方法检测两组标本hTERC基因的表达情况,BE组阳性率为57.9%(22/38),而近端胃肠化黏膜阳性率为13.6%(6/44),两者差异有统计学意义(P〈0.05)。结论在鉴别BE和近端胃肠化黏膜中CK7与CK20表达的意义尚不能肯定;而CK7/CK4/CK8同时阳性可能支持BE的诊断,对鉴别两者有一定作用。SLOOP有可能作为鉴别BE和近端胃肠化黏膜两者的免疫标志物;hTERC基因扩增检测可能有助于BE诊断,并提示BE向食管腺癌发展的过程中该基因可能起重要作用。 Objective To study the clinicopathologic features and differential diagnosis of proximal gastric mucosa and mucosa of Barrett's esophagus (BE) in biopsy specimens. Method Thirty-eight cases of Barrett's esophagus ( diagnosed using WHO criteria) and 44 cases of proximal gastric mucosa were studied by immunohistoehemistry (for CKT, CK20, CK4, CKS, S-100 protein, MUC6, COX2 and bcl-2) and fluorescence in-situ hybridization (FISH) (for hTERC gene ). The pathologic features were analyzed. Results The differences in expression of CK7, CK20, MUC6, COX2 and bcl-2 between BE and proximal gastric mucosa with intestinal metaplasia were not statistically significant ( P 〉 0.05 ). There was however a statistically significant difference in expression of S-100 protein ( P 〈 0. 05 ). The expression of CKT/CK4 and CKT/CK8 in BE showed positive correlation (P 〈 0. 05 ). However, such correlation was not demonstrated in proximal gastric mucosa( P 〉 0. 05 ). The results of hTERC gene expression by FISH showed a statistically significant difference between the two groups: 57.9% (22/38) in BE and 13.6% (6/44) in proximal gastric mucosa ( P 〈 0. 05 ). Conclusions The significance of CK7 and CK20 expression is uncertain in the differential diagnosis between BE and proximal gastric mucosa. On the other hand, positivity for CK7/CK4/CK8 may support the diagnosis of BE and play a role in distinguishing between the two groups. S-100 protein expression and detection of hTERC gene amplification also contribute to the diagnosis of BE.
出处 《中华病理学杂志》 CAS CSCD 北大核心 2013年第1期4-9,共6页 Chinese Journal of Pathology
关键词 BARRETT食管 食管胃接合处 食管肿瘤 原位杂交 荧光 免疫组织化学 Barrett esophagus Esophagogastric junction Esophageal neoplasms In situ hybridization, fluorescence Immunohistochemistry
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