CDX2、Hep在Barrett食管中的表达及其临床意义

Expression and clinical significance of CDX2 and Hep in Barrett's esophagus

目的研究尾型同源盒转录因子2(CDX2)和肝细胞抗原(Hep)在Barrett食管(BE)中的表达情况,探讨两指标对BE的临床诊断价值。方法选取反流性食管炎(RE)25例、BE60例(其中胃底型22例,贲门型20例,肠化型18例)作为研究对象,以正常食管和正常贲门黏膜作为正常对照,采用免疫组化EliVision法检测CDX2及Hep在各组黏膜组织中的表达情况。结果 CDX2在RE、胃底型BE、贲门型BE、特殊肠化型BE各组中的阳性表达率分别为20.0%(5/25)、31.8%(7/22)、35.0%(7/20)、100.0%(18/18)。CDX2在肠化型BE中表达率较其它各组显著升高(P<0.05);在RE、胃底型BE、贲门型BE 3组间的阳性表达率差异无统计学意义(P>0.05)。Hep在反流性食管炎、胃底型BE、贲门型BE 3组中均无表达,在肠化型BE组中表达率为100%(18/18)。结论CDX2和Hep可能参与BE的发展演变过程,CDX2可作为BE诊断的早期标志物,Hep可作为诊断肠化型BE的较特异的标志物。

Objective To analyze the expression of CDX2 and Hep in Barrett＇ s esophagus （BE）, and to study the action of CDX2 and Hep in its Clinical Significance. Methods The study consisted of 25 biopsies with reflux esophagitis （RE） ,60 biopsies with BE （gastric -type BE 22;cardiac -type BE 20;intestinal -metaplasia -type BE 18）. Normal esophageal and normal cardia was normal control. Using immunohistochemistry （ EliVisionTMplus）, the expression of CDX2 and Hep in mucosa was detected in every group. Results The positive rate of CDX2 in RE, gastric - type BE, cardiac - type BE, and intestinal - metaplasia - type BE expression were 20.0% （5/25） ,31.8% （7/22） ,35.0% （7/20） ,and 100.0% （18/18）. The expression of intestinal - metaphase - type BE were higher than those in other groups （ P 〈 0.05 ）. There was no difference among RE, gastric - type BE and cardiac - type BE （ P 〉 0.05）. There was no expression of Hep in RE, gastric - type BE and cardiac - type BE. The positive rate of Hep in intestinal - metaplasia - type BE expression were 100% （18/18）. Conclusion CDX2 and Hep May be involved in evolution of BE. CDX2 can be thought of as an early marker of BE, and Hep can be thought of as a specific marker of intestinal - metaplasia - type BE.