同一个体食管和贲门双源癌前病变组织中Rb的表达

目的 探讨同一个体食管鳞状上皮不典型增生(esophageal epithelial dysplasia,EDYS)和贲门腺上皮不典型增生(gastric cardia dysplasia,GDYS)组织中Rb蛋白表达的变化特征及其意义.方法 采用免疫组化ABC法和组织病理学方法,分析河南食管癌高发区30例同一个体同时发生EDYS和GDYS组织中Rb蛋白的表达情况.结果 Rb在EDYS组织中阳性率为70%(21/30),GDYS组织阳性率为80%(24/30),两者阳性率差异无统计学意义(χ~2=0.800,P>0.05);同一个体EDYS和GDYS组织Rb表达有明显一致性(Kappa=0.561,P<0.01),25例(83%,25/30)同时出现EDYS和GDYS组织Rb表达的一致性改变,一致阳性率为67%(20/30),一致阴性率为17%(5/30);EDYS和GDYS组织中Rb的表达相关(P<0.01).结论 Rb在同一个体EDYS和GDYS组织中存在较高的表达一致性改变,进一步提示食管鳞癌和贲门腺癌可能具有相似的发病因素和分子机制.

Expression of Rb in precancerous lesions of esophagus and gastric cardia in same patients

Purpose To characterize the alterations and significance of Rb in concurrent esophageal and gastric cardia precancerous lesions (dysplasia) from the same patients in Henan,a high-incidence area of esophageal carcinoma.Methods Rb protein expression was detected by the immunohistochemical staining (ABC method) in 30 patients with both esophageal and gastric cardia dysplasia in Henan area.Results Rb positive rates in esophageal epithelial dysplasia (EDYS) and gastric cardia dysplasia (GDYS) were 70% (21/30) and 80% (24/30), respectively, and the difference was not significant,(χ~2=0.800,P>0.05).However, there were 25 patients with Rb coincident changes in EDYS and GDYS from the same patient in 30 cases of esophageal and gastric cardia dysplasia (83%,25/30). The positive coincidence rate for Rb positive expression in EDYS and GDYS from the same patient accounted for 67% (20/30) and the negative coincidence rate was 17% (5/30) (Kappa=0.561,P<0.01).The significant relationship between Rb coincidence expression in EDYS and GDYS was found (P<0.01).Conclusions The high coincident alterations of Rb in EDYS and GDYS from the same patient indicate the possibility of similar molecular basis, which provides an important etiological clue for the similar geographic distribution and risk factors involved in esophageal squmaous cell carcinoma and gastric cardia adenocarcinoma.