P53、Bcl-2在正常食管黏膜、Barrett食管及食管腺癌中的表达及临床意义

Expressions of P53 and Bcl-2 in normal esophageal mucosa,Barrett esophagus and esophageal adenocarcinoma and its clinical significance

[目的]通过免疫组织化学技术探讨P53、Bcl-2在正常食管黏膜、Barrett食管、食管腺癌中的表达探讨及临床意义及其相关性。[方法]收集我院2011-2013年内镜活检的明确诊断的Barrett食管、食管腺癌及正常食管黏膜组织标本各30例,并将Barrett食管根据异型增生程度分为不伴不典型增生、轻度不典型增生、中度不典型增生、重度不典型增生。应用免疫组织化学技术检测其p53及Bcl2的表达。[结果]90例患者中正常食管黏膜30例、11例不伴不典型增生、9例轻度不典型增生、5例中度不典型增生、5例重度不典型增生、30例食管腺癌各组中Bcl-2蛋白表达阳性率分别为3.3%、6.7%、9.1%、22.2%、40%、60%、70%;BCL2表达强度随Barrett食管不典型增生增生程度依呈递增趋势,各组间比较,差异有统计学意义。各组中p53蛋白表达阳性率则分别为6.7%、18.2%、33.3%、40%、80%、80.0%,除重度不典型增生与食管腺癌组间差异无显著性意义外,其它各组间差异有统计学意义（P〈0.05）。[结论]随着Barrett食管不典型增生程度的加重,Bcl-2、P53也随之升高。p53、Bcl-2过度表达与Barrett食管进展到食管腺癌有相关性。

[Objective]To explore the expressions of P53 and Bcl-2by immunohistochemical techniques in normal esophageal mucosa,Barrett esophagus,esophageal adenocarcinoma and to explore the clinical significance and relevance.[Methods]From January 2011 to June 2013 esophageal mucosa from Barrett＇s esophagus,esophageal aden ocarcinoma and normal tissues were collected in our hospital（30cases in each group）.According to atypical proliferous degree,Barrett＇s esophagus was divided into all atypical hyperplasia degree of dysplasia,mild dysplasia,moderate dysplasia and severe dysplasia.The expression of Bcl-2and p53 protein was detected by immunohistochemical method.[Results]Ninety patients inclueded 30 cases of normal esophageal mucosa,11 without atypical hyperplasia,9of mild dysplasia,5of moderate dysplasia,5of severe atypical hyperplasia.In 30 cases of esophageal adenocarcinoma,the positive expression of Bcl-2in each group was 3.3%,6.7%,9.1%,22.2%,40%,60%,70%respectively.BCL 2expression intensity with Barrett＇s esophagus showed an increasing trend in accordance with the degree of proliferation with statistical difference among the groups.The positive expression of p53 protein was 6.7%,18.2%,33.3%,40%,80%,86.7%,with significant difference between these groups except that between severe atypical hyperplasia and esophageal adenocarcinoma group（P〈0.05）.[Conclusion]With Barrett＇s esophagus dysplasia progressesion,Bcl-2and P53 increased.P53,Bcl-2overexpression had close correlation with the development of Barrett＇s esophagus to esophageal adenocarcinoma.