【作者】 王俊宽；

【导师】 王立东；

【作者基本信息】 郑州大学 ， 内科学， 2006， 硕士

【摘要】 研究背景 河南林州地区是食管鳞癌(Esophageal squamous cell carcinoma，SCC)高发区同时也是贲门癌(Gastric cardia adenocarcinoma，GCA)高发区。近二十年来，西方国家食管贲门交界部腺癌的发病率明显上升，并认为反流性食管炎-Barrett’s食管(肠上皮化生)-不典型增生-食管或食管贲门交界部腺癌是该部位主要发病模式。但是，与西方国家明显不同的是，中国食管癌高发区95％以上为食管鳞癌，食管腺癌的发生率，反流性食管炎，特别是Barrett’s食管的发生率均较低，所观察到的贲门癌也主要位于齿状线下方。贲门癌旁肠上皮化生(Intestinal metaplasia，IM)的特征及其与GCA的关系尚不清楚。本课题组以往的研究发现IM可能是GCA的癌前病变，但西方国家的学者认为贲门部的IM不具有癌变风险。这些研究提示河南GCA高发区IM及GCA可能具有独特的发生机制和分子变化特点。文献报道CK7、CK20和CD10能够区分胃食管交界部IM和腺癌的来源，来自食管的IM和腺癌分别特异表达“Barrett’s CK7/CK20模式”和“CK7+／20-模式”，而来源于贲门的组织不具有这种特点。CDX2是一种肠道上皮特异性基因，在早期的胃IM组织甚至尚未出现杯状细胞时就已有表达。本研更多还原

【Abstract】 BackgroundLinzhou and nearby counties in Henan Province are the high incidence area for esophageal squamous cell carcinoma (SCC) and gastric cardia adenocarcinoma (GCA). In the last two decades, adenocarcinoma at gastro-esophageal junction (GEJ) has increased dramatically in western countries and the sequence from reflux esophagitis-Barrett’s esophagus (intestinal metaplasia) -dysplasia-adenocarcinoma has been hypothesized as the histogenesis model for the adenocarcinoma originated at GEJ in western countries. Comparing with western country, distinctly difference is 95% esophageal cancer is SCC in Linzhou. The incidences of esophageal adenocarcinoma, reflux esophagitis and especially Barrett’s esophagus are much lower in Chinese population. And most of GCA occurs below the Z-line in China. The prevalence of IM adjacent to GCA and its relation with GCA has not been well characterized. Our research group found that intestinal metaplasia (IM) might be a更多还原