贲门癌高、低发区居民贲门癌前病变和癌组织中MUC3蛋白表达的比较

Alterations of MUC3 in gastric-cardia precancerous and cancerous lesions: a comparative study between the high-and low-risk populations

目的 :探讨贲门癌高、低发区人群贲门癌变过程中MUC3表达变化特征及其与病变发生发展的关系。方法 :采用免疫组织化学 (ABC)法和组织病理学方法 ,对来自河南省贲门癌高发区 6 3例、低发区 10 3例无症状居民贲门粘膜活检组织和高发区 70例、低发区 39例贲门癌 (GCA)手术切除组织的MUC3的表达进行分析。结果 :贲门癌高、低发区居民贲门上皮各级病变 ,均有不同程度的MUC3蛋白表达 ,从慢性浅表性贲门炎 (CSG)→慢性萎缩性贲门炎 (CAG)→不典型增生 (DYS)→贲门癌 (GCA) ,MUC3蛋白表达免疫阳性率高发区分别为 13%、4 4 %、2 9%和38% ,低发区分别为 13%、13%、5 0 %和 33%。结论 :低发区人群贲门癌变演进过程中MUC3阳性表达率呈逐渐升高的趋势 ,DYS阶段的变化最明显 ,而高发区居民CAG阶段阳性率最高 ,提示 2者可能存在不同的危险因素和发病机制。

Aim: To further elucidate the possible mechanisms of gastric cardia carcinogenesis and the relationship between alterations of MUC3 and lesion progress on the subjects from HIA and LIA for GCC.Methods: Immunohistochemistry (ABC) and morphological analysis method were undertaken to determine the expression of MUC3 in gastric cardia carcinogenesis. 166 biopsies with different lesions were selected randomly from the mass survey data bank (63 from the HIA, 103 from the LIA). 109 surgical resected GCA specimens (70 from the HIA, 39 from the LIA) were also collected for the study. Results: In the HIA, with the lesions progressed from CSG→CAG→DYS→GCA, the positive rates of MUC3 expression were 13%, 44%, 29% and 38%, respectively, espercially the highest is in the stage of GCA; In the LIA, with the lesions progressed from CSG→CAG→DYS→GCA, an increasing tendency of MUC3 expression was observed, and the positive expression rates were 13%, 13%, 50% and 33%, respectively, espercially the highest is in the stage of DYS. Conclusion: In contrast with the population at the HIA,where the highest rate of MUC3 positive immunostaining is in the stage of GCA, a remarkable increasing tendency for MUC3 positive immunostaining was observed with the lesions progression from the population at the LIA, especially in the stage of DYS. This difference indicated that there may be some different mechanism in gastric cardia carcinogenesis at different area.