【作者】 叶春荣；

【导师】 王雯；

【作者基本信息】 福建医科大学 ， 内科学， 2008， 硕士

【摘要】 目的:通过对人Barrett食管(BE)、食管腺癌(EA)、贲门肠化(CIM)及贲门癌(CA)标本进行MUC1、MUC3、MUC6的检测,揭示上述三种因子在BE、EA、CIM和CA发生发展中的作用,以及在BE与CIM、EA与CA鉴别中的意义。方法:经胃镜、病理确诊的BE患者50例、CIM50例,分别取其粘膜作为BE组和CIM组,取胃镜活检或手术切除经病理确诊的EA标本25例,CA标本50例,分别作为EA组和CA组。分别取正常食管鳞状上皮20例、正常贲门粘膜20例作为正常对照组。进行免疫组化染色观察各组标本中MUC1、MUC3、MUC6蛋白的表达情况,并进行组间比较。结果:①BE组MUC1的表达高于正常食管鳞状上皮组(P<0.01),而低于EA组(P<0.01);BE组MUC3、MUC6表达高于正常食管鳞状上皮组(P<0.01),且高于EA组(P<0.01)。②CIM组MUC1的表达低于CA组(p<0.01);CIM组MUC3的表达高于正常贲门粘膜上皮组(P<0.01),高于CA组(P<0.01);CIM组MUC6的表达低于正常贲门粘膜上皮组(P<0.01),低于CA组(P<0.01)。③MUC1、MUC6在BE和CIM、EA和CA两组疾病中的表达,差别具有统计学意义(P<0.05),而MUC3在上述两组疾病中的表达无差别(P>0.05)。④MUC1蛋白的表达与EA细胞分化程度呈负相关(P<0.05),与EA病理学分期呈正相关(P<0.05),与CA的淋巴结转移、病理学分期呈正相关(P<0.05);MUC3蛋白的表达与EA、CA细胞分化程度呈负相关(P<0.05);MUC6蛋白的表达与EA、CA的临床病理因素无关(P>0.05)。结论:MUC1、MUC3、MUC6的表达变化与BE、EA、CIM和CA的发展呈正相关;MUC1的表达与EA细胞分化程度、病理学分期相关,与CA的淋巴结转移、病理学分期相关,MUC3的表达与EA、CA细胞分化程度呈负相关。MUC1、MUC6在BE和CIM、EA和CA中的表达不同(P<0.05),通过免疫组化方法检测MUC1、MUC6的表达水平可能成为鉴别BE和CIM、EA和CA的一条新途径。更多还原

【Abstract】 Background and Objective: The incidence of esophageal adenocarcinoma(EA) and cardia adenocarcinoma(CA) arises greatly over the last 3 decades. Barrett’s esophagus(BE) and cardia intestinal metaplasia(CIM) are respectively the pathological changes before the cancer of EA and CA. MUC1,MUC3 and MUC6 are some of the important tumor marks.The aim of this study is to discover the role of MUC1, MUC3 and MUC6 in the pathogenesis of BE, EA, CIM and CA.Methods: The expressions of protein of MUC1, MUC3 and MUC6 were investigated in normal esophageal squamous epithelium(n=20),normal cardia epithelium(n=20), BE(n=50), CIM(n=50), EA(n=25) and CA(n=50) using immunohistochemical staining respectively. The differences among the groups were compared.Results:①The protein expression of MUC1 was little in normal esophageal squamous epithelium, it was more in BE and the most in EA.There was a statistically difference in MUC1 expression(P<0.01) among these three groups. The protein expression level of MUC3 and MUC6 was lower in normal esophageal squamous epithelium than that in BE(P<0.01), but higher in EA(P<0.01).②An increasing intendency of the level of MUC1 expression was observed from normal cardia epithelium to CIM and CA. There was a statistically difference in MUC1 expression(P<0.01) between CIM and CA. The expression of MUC3 was more in CIM than that in normal cardia epithelium(P<0.01),but the expression of MUC6 was less(P<0.01).③There was a statistically difference in MUC1 and MUC6 expressions(P<0.05) between BE and CIM, and between EA and CA. But no difference in MUC3 expression(P>0.05).④There was significant correlation between the expression of MUC1 and cell difference of CA or lymphatic spread or pathologic stage in CA or in EA(P<0.05). There was also correlation between the expression of MUC3 and cell difference of EA or CA (P<0.05), but no correlation between the expression of MUC6 and all the factors of clinic or pathology(P>0.05).Conclusions: There may be close relation between the expressions of MUC1, MUC3 or MUC6 and the development from BE to EA or from CIM to CA. There is correlation between the expression of MUC1 and MUC6 and some factors of clinic or pathology of EA and CA.Monitoring these targets may provide valuable information to the diagnosis, treatment and prognosis of EA or CA. It may be a new way to distinguish BE from CIM or EA from CA by detecting the expressions of MUC1 and MUC6.更多还原