食管癌前病变和癌组织中增生细胞核抗原与细胞凋谢变化的关系

为探讨细胞凋谢与细胞增生在食管癌变过程中变化的关系，计数１９４例食管粘膜活检组织切片单位面积（ｍｍ２）中增生细胞核抗原（ＰＣＮＡ）免疫阳性细胞数和凋谢细胞数，对其进行定量分析。结果：在食管正常上皮，ＰＣＮＡ免疫阳性细胞数量低，从食管正常上皮到基底细胞增生，ＰＣＮＡ免疫阳性细胞数稍有升高，到间变时明显升高，到癌时升高最显著，为正常上皮的近７倍（Ｐ＜０．０１）。在各级病变组织中，凋谢细胞数较低，在正常上皮中更低。随病变加重（基底细胞增生→间变→癌），单位面积凋谢细胞数均逐渐升高（Ｐ＜０．０１）。细胞凋谢指数与细胞增生指标ＰＣＮＡ呈显著正相关（ｒ＝０．３６３，Ｐ＜０．０１）。提示：细胞凋谢不仅可以反映食管癌变过程中上皮细胞的死亡状况，而且能反映细胞增生状况。

Correlation between proliferating cell nuclear antigen and apoptosis in esophageal precancerous and cancerous lesions

The object of this study was to quantify the extent of apoptosis and to correlate it with cell proliferation as determined by proliferating cell nuclear antigen (PCNA) in esophageal carcinogenesis.Quantitative analysis of apoptosis and PCNA of 194 esophageal mucosal biopsies was performed by recording the apoptotic cells and PCNA immunostaining positive cells per mm 2 of the tissue section.The results showed that the number of PCNA immunostaining positive cells was low in mormal esophageal epithelia, slightly increased in basal cell hyperplasia(BCH),markedly increased in dysplasia (DYS) and further increased in squamous cell carcinoma (SCC), nearly 7 fold(P<0.01).The number of apoptotic cells was lower in different degrees of lesions and much lower in normal esophageal epithelia than that of PCNA and increased with the lesions progressing from BCH to DYS and SCC (P<0.01). The apoptotic cells were mostly located in the lower third layer of the esophageal epithelium,which was the proliferative compartment.A good correlation was observed between the apoptotic index and the cell proliferation as determined by PCNA(r=0.363,P< 0.01 ).The present results indicated that apoptosis was not only a biomarker for cell death,but also for cell proliferation in esophageal carcinogenesis.