Cdx2和MUC2在反流性食管炎、Barrett食管和食管腺癌中的表达

目的研究Cdx2和MUC2在反流性食管炎、Barrett食管和食管腺癌中表达，探讨3种食管黏膜疾病的内在关系。方法选取反流性食管炎30例、Barrett食管18例及食管腺癌25例作为研究对象，以正常食管上皮黏膜25例作为对照，采用免疫组化方法检测Cdx2和MUC2的表达，对结果进行统计分析。结果Cdx2和MUC2在反流性食管炎、Barrett食管及食管腺癌中的蛋白阳性表达率均较正常对照组明显增高（P〈0．05）。Cdx2在正常食管黏膜上皮中无表达，在反流性食管炎、Barrett食管及食管腺癌中的阳性表达率分别为26．7％、66．7％和28．0％，在Barrett食管中表达明显高于反流性食管炎（P〈0．05），亦明显高于食管腺癌（P〈0．05）；MUC2在正常食管黏膜上皮和反流性食管炎组织无表达，在Barrett食管及食管腺癌中的阳性表达率分别为61．1％和24．0％，Barrett食管中表达率明显高于食管腺癌（P〈0．05）。两者表达情况相似。结论Cdx2是肠上皮化生的始动因素，MUC2的表达是肠上皮化生的晚发事件。Cdx2和MUC2在反流性食管炎、Barrett食管和食管腺癌组织中的表达情况支持这3种食管黏膜疾病间有密切的关系。

Expression of Cdx2 and MUC2 in reflux esophagitis barrett's esophagus and esophageal adenocarcinoma

Objective In order to investigate the relationship among reflux esophagitis,Barrett's e- sophagus and esophageal adenocarcinomas,the expressions of Cdx2 and MUC2 gene were studied.Methods Using immunohistochemistry,the expressions of the Cdx2 and MUC2 were detected in the esophageal mu- cosa of 30 patients with reflux esophagitis,18 patients with Barrett's esophagus and 25 patients with esopha- geal adenocareinoma.Results The positive rate and staining intensity of Cdx2 and MUC2 expressions in re- flux esophagitis,Barrett's esophagus and esophageal adenocarcinoma were significantly higher than those in normal esophageal mucosa(P<0.05).Cdx2 was expressed in 26.7% patients with reflux esophagitis, 66.7% patients with Barrett's esophagus,and 28% patients with esophageal adenocarcinoma,whereas,it was negative in the normal esophageal mucosa.Expression of Cdx2 in Barrett's esophagus was significantly higher than that in reflux esophagitis(P<0.05).Expression of Cdx2 in esophageal adenocarcinoma was lower than that in Barrett's esophagus significantly(P<0.05).MUC2 expression was negative in the normal esophageal mucosa and reflux esophagitis,while it was positive in 61.1% patients with Barrett's esophagus,and in 24% patients with esophageal adenocarcinoma.The expression of MUC2 in esophageal adeuocarcinoma was signifi- cantly lower than that in Barrett's esophagus(P<0.05).The expression of Cdx2 had a similar pattern with MUC2.Conclusion Cdx2 is a trigger of intestinal metaplasia,while MUC2 is a later event of intestinal met- aplasia.This study on the expression of Cdx2 and MUC2 in the three kinds of esophageal lesion deduces that there is a close relationship among them.