食管癌患者淋巴结转移灶DNA含量测定在预后判断中的意义

为了探讨食管癌患者癌周淋巴结转移(LNM)灶细胞DNA含量及其相关指标测定的预后意义,本文采用流式细胞术对64例食管癌癌周LNM灶细胞DNA含量进行检测,并对癌周LNM灶细胞的细胞生物学特性和患者预后的关系进行分析.食管癌癌周LNM灶细胞的DI值、H-检出率、SPF和PI均显著高于相应的对照组淋巴结,Apo却显著低于对照组;癌周LNM灶DNA二倍体者、倍体同质体者、SPF降低者、PI降低者、Apo升高者的术后生存期和5年生存率均显著高于DNA异倍体者、倍体异质体者、SPF升高者、PI升高者和Apo降低者.随癌周淋巴结转移阳性率的升高,患者生存期和5年生存率均逐渐降低,部分呈显著负相关关系. 结论:食管癌癌周LNM灶细胞DNA倍体变化是恶性肿瘤的重要生物学特性之一,其生物学特性和患者预后关系十分密切.因此,癌周LNM灶细胞的生物学参数可作为判断食管癌患者预后的重要参考及量化指标.     

甲状腺乳头状癌 ALDH1A1表达与淋巴结转移的相关性

目的探讨甲状腺乳头状癌（ PTC）中ALDH1A1的表达情况及与淋巴结转移的相关性。方法收集首都医科大学附属北京同仁医院病理科2006年1月至2013年12月间PTC腺叶切除＋淋巴结清扫标本153例,在HE染色下观察其一般临床病理学特点（肿物直径、双侧、多灶、肿瘤边界、腺叶外浸润）,并采用免疫组织化学染色EnVision法,检测癌及癌旁组织中ALDH1A1的表达情况,分析ALDH1A1表达与淋巴结转移的关系。结果在153例PTC中,84例（54.9％）发生淋巴结内癌转移,126例癌组织高表达ALDH1A1,112例癌旁组织高表达ALDH1A1。通过单因素分析,发现年龄＜45岁、肿物直径＞10 mm、浸润性边缘及癌组织 ALDH1A1高表达与淋巴结转移明显相关（P＜0.05）。而性别、双侧、多灶、腺叶外浸润、癌旁组织ALDH1A1与淋巴结转移无关（P＞0.05）。进一步多因素分析发现浸润性边界和癌组织ALDH1A1高表达是PTC淋巴结转移的独立危险因素（P＜0.05）。在随访的82例PTC中,局部肿瘤复发4例,5年局部复发率为4.88％,包括淋巴结肿瘤复发3例和甲状腺肿瘤复发1例,无远处转移及疾病相关死亡病例。复发病例肿瘤组织ALDH1A1均为高表达。结论 ALDH1 A1在PTC癌组织内高表达与淋巴结转移明显相关,可作为PTC淋巴结转移的有效预测因子,有利于改善PTC患者治疗方法及随访方案。     

骨桥蛋白在食管鳞癌中的表达及其临床意义

目的观察骨桥蛋白（OPN）在食管鳞癌组织、癌旁组织和转移淋巴结的表达状况，探讨OPN在食管鳞癌中表达的临床意义。方法运用免疫组化S-P法检测44例食管鳞癌组织、癌旁组织和20例转移淋巴结免疫组化染色。结果OPN在食管癌组织、癌旁组织及转移淋巴结中的表达率分别为86．3％、0％和100％。癌组织中OPN主要表达于肿瘤细胞的细胞浆中。OPN的表达与肿瘤TNM分期、淋巴结转移状态有关，而与肿瘤位置、肿瘤直径、浸润深度及病理学分级无关。OPN在癌组织、癌旁组织及转移淋巴结表达强度亦存在显著性差异。结论食管鳞癌组织中OPN主要由肿瘤细胞产生。OPN与肿瘤的浸润、转移有关，反映了肿瘤的生物学特性。     

大肠癌原发灶及淋巴结转移灶中TS和Topo-Ⅱ表达的对比分析

目的探讨胸苷酸合成酶（TS）和拓扑异构酶II（Topo-Ⅱ）在大肠癌原发灶及淋巴结转移灶的表达及临床意义。方法应用组织芯片及免疫组化技术,检测TS和Topo-II在135例大肠癌和60例淋巴结转移灶的表达情况。结果 TS在135例大肠癌和癌旁正常黏膜组织中的阳性表达率分别为54.81%和42.96%,差异无统计学意义（P〉0.05）,大肠癌TS表达与各临床病理参数无关（P〉0.05）,60例大肠癌淋巴结转移灶中TS阳性表达率为41.67%,与原发灶TS阳性表达率（53.33%）比较差异无统计学意义（P〉0.05）及无相关性（r=0.045,P=0.732）。Topo-II在135例大肠癌和癌旁正常黏膜组织中的阳性表达率分别为53.33%和21.48%,差异有统计学意义（P〈0.05）,Topo-Ⅱ阳性表达率与大肠癌组织学分级有关,中分化腺癌高于高分化腺癌（P〈0.05）,60例大肠癌原发灶中Topo-Ⅱ阳性表达率（56.67%）显著高于淋巴结转移灶（31.67%,P〈0.05）且呈正相关（r=0.261,P=0.044）。结论大肠癌原发灶与淋巴结转移灶TS和Topo-Ⅱ蛋白表达存在一定的差异,淋巴结转移灶耐药蛋白表达的检测对术后体内残存肿瘤细胞耐药性评估可能更为客观。     

RhoGDI2在结直肠癌中的表达及临床意义

目的：探讨RhoGDI2在结直肠癌中表达及临床意义。方法：通过免疫组化检测 RhoGDI2 在结直肠癌组织、癌旁组织及转移淋巴结中表达,分析其与CRC患者临床因素及生存期之间的关系。结果：RhoGDI2在癌旁组织、肿瘤原发灶及转移淋巴结中表达逐渐升高,差异有统计学意义（P＜0.001）; RhoGDI2表达与淋巴结转移、远处转移关系密切（P＜0.05）;高表达RhoGDI2者总生存期及无病生存期短。结论：RhoGDI2在结直肠癌组织中高表达,且与结直肠癌淋巴结转移、远处转移明显相关,高表达RhoGDI2者总生存期及无病生存期短。     

食管癌组织中血管内皮生长因子的表达对树突状细胞的影响

目的：研究食管癌组织中血管内皮生长因子（VEGF）的表达对树突状细胞（DC）的影响。方法：对94例食管癌组织采用辣根过氧化物酶（HRP）标记的链霉亲和素-生物素法（LSAB）,分别检测VEGF、S100蛋白的表达水平,并分析VEGF与S100^＋ DC的相关性。结果：食管癌组织中VEGF的表达率为74.46%（70/94）,VEGF的表达与患者的临床分期及癌组织的分化呈正相关（r=0.864,0.803,P〈0.05）。临床分期越晚,病癌组织的分化越低,癌组织内S100^＋ DC的密度越小（r=-0.763,-0.908,P〈0.05）。随着癌组织内VEGF表达量的上升,S-100^＋ DC的密度降低,二者呈负相关（r=-0.817,P〈0.05）。结论：食管癌组织中VEGF的表达可降低S100^＋DC的密度,从而影响机体的免疫功能。     

SAMD9在食管鳞癌中的表达及其意义

目的研究SAMD9(sterile alpha motif domain-containing 9)在食管癌中表达和临床意义。方法选取72例手术切除食管癌及癌旁组织,采用免疫组织化学染色法检测SAMD9在食管癌及癌旁组织表达差异,并分析其在食管癌组织表达临床意义。另外选取3例手术时已发生转移及3例手术时未发现任何转移的食管癌组织,Western blot法检测SAMD9在2组中表达差异。结果 SAMD9在食管癌组织及癌旁食管鳞状上皮细胞中表达无明显差异;SAMD9在食管癌组织中表达水平与患者淋巴管浸润及淋巴结转移密切相关(P0.05),而与患者性别、年龄、分化及T分期无明显相关性(P0.05)。Western blot法结果显示SAMD9在转移性食管癌组织中表达水平显著强于非转移性食管癌组织(P0.01)。结论 SAMD9在食管癌组织中表达水平与转移密切相关。     

Smad4在人食管癌中的表达

目的探讨Smad4蛋白在食管癌中的表达及其意义。方法应用组织微阵列联合免疫组织化学方法检测45例食管癌及其癌旁正常组织中Smad4蛋白的表达情况;选择其中10例患者的肿瘤组织、癌前病变组织及正常组织的新鲜标本,采用Western blot检测Smad4表达。结果Smad4在食管正常组织中表达的阳性率高于癌组织(P<0.05),在没有淋巴结转移的食管癌组织中表达的阳性率明显高于(P<0.001)有淋巴结转移的癌组织。结论Smad4在食管癌和有淋巴结转移的食管癌低表达。     

TIMP-3基因甲基化与结直肠癌临床病理的关系

目的：探讨TIMP-3基因甲基化与结直肠癌临床病理指标和转移复发的关系。 方法： 采用巢式甲基化特异性PCR技术（nMSP法）检测100例结直肠癌组织和100例癌旁非癌组织TIMP-3基因甲基化；采用RT-PCR检测100例结直肠癌组织和100例癌旁非癌组织TIMP-3 mRNA的表达。 结果： 肿瘤组织TIMP-3 mRNA的表达阳性率为64%，肿瘤组织TIMP-3 mRNA的表达率明显低于癌旁非癌组织（P＜0.01）；TIMP-3 mRNA的表达率无淋巴结转移组（34/42）高于淋巴结转移组（30/58）（P＜0.01），甲基化阳性率Duke’s C+D期伴淋巴结转移组明显高于Duke’s A+B期不伴淋巴结转移组（P＜0.05）。结肠近端、分化程度差的结直肠癌组织甲基化阳性率明显高于远端直肠和分化程度高者（P＜0.05）。 结论： TIMP-3基因甲基化容易发生在结肠近端、Duke’s C、D期、伴淋巴结转移、细胞分化差和浸润型结直肠癌患者。     

p63蛋白在食管磷状细胞癌中的表达及意义

目的检测p63蛋白在食管癌组织中的表达情况,并探讨其与食管癌临床病理特征的关系。方法采用免疫组化检测p63蛋白在53例食管磷癌及癌旁组织中的表达情况。结果p63蛋白在食管癌组织中的阳性表达率为71.7%（38/53）,而在癌旁食管组织中的阳性表达率为35.8%（19/53）,两者比较有显著性差异（P〈0.01）。p63蛋白的表达与食管磷癌分化程度密切相关（P〈0.05）,其在低分化磷癌中的阳性表达率（89.5%）显著高于在高分化磷癌中的阳性表达率（46.2%）。p63蛋白的表达与食管磷癌的TNM分期、淋巴结转移、浸润深度均无明显相关性（P〉0.05）。结论p63蛋白在食管磷癌组织中呈高表达,表明其可能参与食管磷癌的发生发展。     

Overexpression of p53 protein associates decreased response to chemoradiotherapy in patients with esophageal carcinoma.

Induction chemoradiotherapy before esophagectomy for esophageal carcinoma seems to improve patient survival. Given the toxicity of this regimen, it would be useful to predict those patients likely to benefit. p53 is known to mediate apoptosis in response to DNA damage, but there are few data evaluating the relationship between p53 expression and chemoradiosensitivity in human tissues. We immunohistochemically evaluated p53 protein expression in 95 biopsy specimens from patients with esophageal carcinoma before chemoradiotherapy. p53 expression was correlated to the pathologic response identified in subsequent esophagectomy specimens. p53 immunoreactivity was recorded semiquantitatively using the following scale: neg, < 5%; 1+, 5-25%; 2+, 26-50%; 3+, 51-75%; 4+, > or = 76%. Pathologic response in esophagectomy specimens was categorized as overt residual tumor (ORT), minimal residual tumor, and no residual tumor. Of the 95 patients, 64 had adenocarcinoma, and 31 had squamous cell carcinoma. Of those with adenocarcinoma, 46 (72%) of 64 were positive for p53. Thirty-seven (80%) of 46 p53+ patients had ORT, compared with 4 (22%) of 18 p53- patients (P < .001). There was no correlation between the degree of p53 staining and pathologic response. Of those with squamous cell carcinoma, 13 (42%) of 18 were positive for p53. Three (23%) of 13 p53+ patients had ORT, compared with 4 (22%) of 18 p53- patients (P = .96). Our data indicate that overexpression of p53 protein is associated with decreased responsiveness to induction chemoradiotherapy in patients with esophageal adenocarcinoma but that no such association exists in patients with esophageal squamous cell carcinoma.     

Gastroesophageal reflux in asthmatic patients: an incidence study and clinical correlation

The prevalence of gastroesophageal reflux (GER) in asthmatic patients is elevated, but the exact frequency remains unknown. The relationship between GER and asthma has not been investigated in Mexico. The objective of this study is to know the frequency of GER in Mexican asthmatic patients and the possible relationship with the severity of asthma. Fifty patients with adult-onset asthma were studied. AII of them fulfill the diagnostic criteria of the National Institutes of Health, U.S. The evaluation included a symptoms questionnaire, spirometry, esophageal manometry, 24-h esophageal pH-recording, and an upper gastrointestinal endoscopy. Twenty-three patients had mild asthma (46%), 16 moderate (32%) and 11 had severe asthma (22%). Twenty-seven (54%) reported heartburn and regurgitation at least twice a week. The esophageal pH-recording showed pathologic GER in 37 subjects (74%) and endoscopic esophagitis was found in 7 cases (14%). The pH-recording showed pathologic GER in 13 patients with mild asthma (57%), in 13 with moderate asthma (81%) and in all patients with severe asthma (100%). The frequency of GER in Mexican asthmatic patients is high and increases proportionately with the severity of asthma. This factor must be considered in the integral evaluation of these patients.     

新疆哈族和汉族食管癌中Toll样受体的表达及其与肿瘤细胞浸润和转移的关系

目的探讨Toll样受体TLR 4、7、9 mRNA和蛋白在新疆不同民族食管癌组织中的表达及其与肿瘤浸润和转移之间的关系。方法应用实时荧光定量PCR(qRT-PCR)法检测40例食管癌及相应癌旁组织中TLR4、7、9 mRNA的表达。采用免疫组化SP法检测90例食管癌及相应癌旁组织中TLR4、7、9蛋白的表达。结果 TLR7、9 mRNA在食管癌中的表达量明显高于癌旁组织(P<0.05);TLR4 mRNA在食管癌中的表达量与癌旁组织中的表达,差异无统计学意义(P>0.05)。TLR4、7、9 mRNA在汉族食管癌患者组织中的表达均高于新疆哈萨克族(哈族)(P<0.05)。TLR4、7、9蛋白在食管癌组织中的表达明显高于癌旁组织(P<0.05)。TLR4表达与肿瘤淋巴结转移密切相关(P<0.05);TLR7表达与肿瘤浸润深度相关(P<0.05);TLR4、7、9蛋白表达与肿瘤的分化程度密切相关(P<0.05)。TLR4蛋白在食管癌组织间质炎细胞中高表达与肿瘤的浸润和转移有关,而TLR9蛋白在食管癌组织间质成纤维样细胞中高表达与肿瘤的低浸润和低转移密切相关(P<0.005)。结论TLR4、7、9在食管癌中的高表达与食管癌生物学行为密切相关,提示该基因在食管癌的发生、发展、浸润及转移中起一定作用,其族群差异可能反应不同族群的遗传背景及肿瘤的发病机制。     

Pathologic prognostic factors in esophageal squamous cell carcinoma: a follow-up study of 74 patients with or without preoperative chemoradiation therapy.

One of the primary goals of pathologic examination of esophageal squamous cell carcinoma resection specimens is to provide information regarding morphologic features which can help prognosticate and guide management of affected patients. The purpose of this study was to determine the prognostic utility of a variety of histopathologic prognostic factors in patients with esophageal squamous cell carcinoma with and without preoperative chemotherapy and radiotherapy (chemrad). Multiple clinical and histologic features such as peri-tumoral lymphocytic infiltrate, Crohn's-like lymphoid reaction, degree of residual tumor, mitosis per 1000 cells, tumor differentiation, lymphatic/vascular invasion, perineural invasion, desmoplastic reaction, and tumor growth pattern were evaluated in patients with (53) and without (21) preoperative chemrad and correlated with survival (mean follow-up, 25 mo). Data were analyzed for the entire cohort and for each separate treatment group by univariate and multivariate analysis. Patients who received chemrad showed no significant survival benefit (hazard ratio = 2.5, P = .10). In the whole cohort of patients, higher pathologic stage (P = .04), poor tumor differentiation (P = .003), increased mitotic count (P = .005), perineural invasion (P = .01), lymphatic/vascular invasion (P = .002), tumor size (P = .05), and absence of a Crohn's-like lymphoid reaction (P = .05) were significantly associated with poor survival by univariate analysis. In multivariate analysis, poor tumor differentiation (P = .005), high mitotic count (P = .01), and vascular invasion (P = .03) were important prognostic features, independent of pathologic stage, for the entire cohort. In the chemrad group only, tumor size (in patients with macroscopic residual tumor) (P = .05), lymph node metastasis (P = .03), mitotic count (P = .01), and lymphatic/vascular invasion (P = .02) were significant prognostic indicators by univariate analysis. Upon multivariate analysis, only lymphatic/vascular invasion (P = .02) and mitotic rate (P = .01) were independent predictors of survival. In the nonchemrad group, only tumor differentiation was significant by both univariate (P = .008) and multivariate analysis (P = .03). The differences in pathologic prognostic factors between chemrad and nonchemrad treated cases suggests that chemrad has a significant effect on the biologic properties of these tumors.     

Clonazepam treatment of pathologic childhood aerophagia with psychological stresses

The treatment of pathologic aerophagia has rarely been discussed in the literature. In this retrospective study, the authors investigated the effects of clonazepam on the management of pathologic childhood aerophagia (PCA) with psychological stresses (PS), but not with mental retardation. Data from 22 consecutive PCA patients with PS (aged 2 to 10 yr), who had been followed up for over 1 yr, were reviewed. On the basis of videolaryngoscopic views, the authors observed that the pathology of aerophagia was the result of reflex-induced swallowing with paroxysmal openings of the upper esophageal sphincter due to unknown factors and also observed that these reflex-induced openings were subsided after intravenous low dose benzodiazepine administration. Hence, clonazepam was administered to treat paroxysmal openings in these PCA patients with PS. Remission positivity was defined as symptom-free for a consecutive 1 month within 6 months of treatment. The results of treatment in 22 PCA patients with PS were analyzed. A remission positive state was documented in 14.3% of PCA patients managed by reassurance, and in 66.7% of PCA patients treated with clonazepam (p=0.032). Thus, clonazepam may produce positive results in PCA with PS. Future studies by randomized and placebo-controlled trials are needed to confirm the favorable effect of clonazepam in PCA.     

食管鳞癌和反流性食管炎中p16和hMLH1基因甲基化的探讨

目的 探讨食管下段鳞癌和反流性食管炎组织中p16基因和hMLH1基因启动子区的甲基化状况,及与其临床病理特征之间的关系.方法 根据胃镜检查及病理学检查确诊正常食管上皮标本12例,食管下段鳞癌13例,反流性食管炎64例(其中基底细胞增生43例、不典型增生21例).提取各个组织的基因组DNA,用甲基化特异性聚合酶链反应法检测p16基因启动子区的甲基化状态;用亚硫酸氢钠-酶切法检测hMLH1基因启动子区的甲基化状态.用免疫组织化学SP法检测蛋白表达情况.结果 正常食管上皮、反流性食管炎中的基底细胞增生和不典型增生,以及食管下段鳞癌组织中p16基因启动子区甲基化率分别为:0/12、14.0%(6/43)、38.1%(8/21)、6/13;并且p16基因启动子区甲基化率随食管病变程度的进展呈逐渐升高趋势;p16蛋白在正常食管上皮组织中均正常表达,基底细胞增生、不典型增生和食管下段鳞癌组织中的阴性表达率分别为:25.6%(11/43)、76.2%(16/21)、11/13;在正常食管上皮和反流性食管炎组织里均未检测出hMLH1基因启动子区甲基化;在食管下段鳞癌组织中1例检测hMLH1基因启动子区甲基化.p16基因启动子区甲基化与蛋白阴性表达密切相关(P＜0.01),而hMLH1基因启动子区甲基化与蛋白表达无显著相关性(P=0.590).结论 p16基因动子区甲基化可能是食管下段鳞癌发生的早期分子事件之一;反流性食管炎的基底细胞增生可能与食管下段鳞癌相关;hMLH1基因启动子区甲基化可能不直接参与食管下段鳞癌的发生.

Abstract：

Objective To study the promoter methylation pattern of p16 and hMLH1 genes in esophageal squamous cell carcinoma and reflux esophagitis, and to correlate the results with clinical and pathologic findings. Methods Twelve cases of normal esophagus, 13 cases of esophageal squamous cell carcinoma, 43 cases of reflux esophagitis with basal cell hyperplasia and 21 cases of reflux esophagitis with dysplasia, as confirmed by endoscopic and pathologic examination, were enrolled into the study. Genomic DNA was extracted. The promoter methylation status of p16 was measured by methylation-specific polymerase chain reaction. The promoter methylation status of hMLH1 was measured by sodium bisulfite-restriction enzyme digestion. Immunohistochemical study for p16 and hMLH1 proteins was also carried out. Results The rates of p16 methylation in normal esophageal epithelium, basal cell hyperplasia, dysplasia and esophageal squamous cell carcinoma were 0/12, 14.0% (6/43), 38.1% (8/21) and 6/13, respectively.The p16 methylation correlated with the progress of esophageal lesions. On the other hand, the hMLH1 methylation was not observed in the normal esophageal epithelium and reflux esophagitis. One case of esophageal squamous cell carcinoma showed the presence of hMLH1 methylation. The hMLH1 promoter hypermethylation did not correlate with the clinical and pathologic features. Conclusions The p16 methylation may be one of the earliest events in the pathogenesis of esophageal squamous cell carcinoma and is also observed in reflux esophagitis. Reflux esophagitis may be related to the development of esophageal squamous cell carcinoma in Chinese population. In contrast, hMLH1 methylation may not be directly involved in the tumorigenesis of esophageal squamous cell carcinoma.     

腹腔镜Heller肌切开术加胃底前180°折叠术治疗贲门失弛缓症经验

目的总结腹腔镜下Heller肌切开术加胃底前180°折叠术治疗贲门失弛缓症的经验。方法 12例贲门失弛缓症患者,其中男性4例,女性8例,年龄35～59岁,平均年龄44.8岁。全部病例于全身麻醉下行腹腔镜下Heller肌切开术加胃底前180°折叠术。结果所有患者术后咽下困难明显改善,无中转开腹手术;平均出血量50 mL,平均住院时间是8.5 d;2例食管黏膜损伤;术后获访的6例,均未出现病理性酸反流症状。结论腹腔镜下改良Heller术治疗贲门失弛缓症效果好,微创,出血少,恢复快,值得推广。     

Associated malformations in patients with esophageal atresia

Esophageal atresia is a common type of congenital malformation. The etiology of esophageal atresia is unclear and its pathogenesis is controversial. Because previous reports have inconsistently noted the type and frequency of malformations associated with esophageal atresia, we conducted this study in a geographically well-defined population, evaluating the birth prevalence of esophageal atresia and associated malformations ascertained between 1979 and 2003 in 334,262 consecutive births. Of the 99 patients with esophageal atresia, 46 (46.5%) had associated malformations. These included patients with chromosomal abnormalities (8 patients, 8%); non-chromosomal recognized syndromes (4 patients), including one each CHARGE syndrome, Fanconi anemia, Fryns syndrome, and Opitz G/BBB syndrome; associations including VACTERL (10 patients), and one schisis; one oculo-auriculo-vertebral spectrum; one malformation complex, a sirenomelia, and non-syndromic multiple congenital anomalies (MCA) (21 patients, 21%). Malformations of the cardiovascular system (24%), urogenital system (21%), digestive system (21%), musculoskeletal system (14%), and central nervous system (7%) were the most common other congenital malformations occurring in patients with esophageal atresia and non-syndromic MCA. We observed a high prevalence of total malformations and specific patterns of malformations associated with esophageal atresia which emphasizes the need to evaluate all patients with esophageal atresia for possible associated malformations. The malformations associated with esophageal atresia could be classified into a recognizable malformation syndrome or pattern in 25 out of 46 patients (54%).     

β-catenin和wnt-1在食管癌组织中的表达及其临床意义

研究β-catenin和wnt-1在食管癌组织中的蛋白表达水平及其与肿瘤病理参数和预后的关系。选取40例具有完整病理资料、手术切除的食管癌蜡块标本和其中10例癌旁组织,应用免疫组化方法检测其β-catenin和wnt-1的蛋白表达水平,比较β-catenin和wnt-1蛋白在组织中的表达差异,及其与食管癌各种临床病理特征和预后的关系。结果显示,β-cate-nin的表达水平与临床分期有相关性（P〈0.05）;wnt-1的表达水平与细胞分化、预后有相关性（P〈0.05）;β-catenin、wnt-1的蛋白表达水平与性别、年龄无相关性（P〉0.05）。wnt-1和β-catenin作为Wnt信号通路的相关蛋白,与食管癌的发展和预后有一定关系。     

半夏泻心汤对反流性食管炎大鼠胃酸、胆汁酸和CGRP的影响

目的:探讨半夏泻心汤防治反流性食管炎的机制。方法:100只胃十二指肠混合反流模型大鼠随机分为伪手术组、模型组、阳性对照组(西沙必利)和半夏泻心汤组(BX);观察反流性食管炎大鼠的食管黏膜组织形态学的变化;采用生化法检测大鼠胃液和十二指肠液的胃酸和胆汁酸的含量;放免法观察大鼠食管黏膜和血浆CGRP的含量。结果:半夏泻心汤可使食管炎大鼠食管黏膜的炎症、鳞状上皮增生和固有层延伸的发生率明显降低、胃酸含量明显减少,食管下端pH值显著升高;与伪手术组相比,模型组食管黏膜中的CGRP含量明显降低,血浆中的CGRP含量明显增高;与模型组相比,半夏泻心汤组食管黏膜中的CGRP含量明显增高。结论:半夏泻心汤可能通过降低食管炎大鼠胃酸分泌,调节体内CGRP的合成和分泌来保护食管黏膜。