食管癌高发区Barrett食管检出率和P_(53)的表达

了解食管癌高发区Ｂａｒｒｅｔｔ＇ｓ食管（ＢＥ）的患病率及ＢＥ与食管腺癌的关系。对３３１例河南省食管癌高发区农村自然人群进行了Ｂａｒｒｅｔ＇ｓ食管的内镜普查和病理组织学检查。同时对１４例来自门诊的Ｂａｒｒｅｔｔ＇ｓ食管病人的活检标本，用免疫组织化学染色的方法检测了抗癌基因Ｐ５３的表达。结果显示：该人群Ｅａｒｒｅｔｔ＇ｓ食管患病率为０．９１％，返流性食管炎的检出率为７．６％。抗癌基因Ｐ５３在１４例Ｂａｒｒｅｔｔ＇ｓ食管标本中阳性表达率为４２％。其中５０％阳性表达的标本伴有不典型增生。Ｐ５３阳性表达可能是Ｂａｒｒｅｔｔ＇ｓ食管上皮到食管腺癌发生过程中一个极早期的改变。对Ｂａｒｒｅｔｔ＇ｓ食管伴有不典型增生或肿瘤基因表达阳性者应视为高危人群，对他们进行重点预防和阻断治疗是必要的。

PREVALENCE OF BARRETT' S ESOPHAGUS AMONG HIGH-RISK POPULATION FOR ESOPHAGEAL CANCER AND EXPRESSION OF P53 PROTEIN IN BARRETT'S ESOPHAGUS

The prevalence of Barrett' s esophagus (BE ) among 331 asymptomatic population living in high-risk area for esophagal cancer was investigated by using endoscopy and histophological examintion. Moreover , expression of P53 , protein was , immunohistochemically , assayed in 14 biopsy speimens obtained from the patients with BE. The prevalence of BE among that rural population was 0.91% , and the incidence rate of reflux esophagitis was 7.6% among the population. Thepositive expression of P53 protein was found in 42% of the 14 patients with BE. Out of thepatients having positive expression of P53 , 50% of the cases were accompanied with dysplasi- a. lt. is suggested that positive expression of P53 may be an early indicator of carcinogenesis from BE to adenocarcinoma of the esophagus , and that the patients with BE accompanied with dysplasia and/or positive expression of a tumour gene are high-risk population. An in- tervention treatment and follow-up examination are necessary for these patients.