卢戈液染色与p53蛋白检测诊断早期食管癌的可行性研究

目的　验证内镜下卢戈液染色和活组织p5 3检测 ,诊断食管早期癌和表浅癌的可行性。方法　将 97例食管癌手术标本先用卢戈液染色 ,然后对粘膜不着色区行p5 3蛋白免疫组化染色。结果　共有 6 3处直径大于 2mm的粘膜不着色区 ,其中正常粘膜 2处 ,单纯增生 7处 ,不典型增生 42处 ,原位癌 1处 ,鳞状细胞癌 11处 ;p5 3蛋白的阳性表达主要发生在重度不典型 (42 3% )和鳞状细胞癌 (45 5 % )的细胞核内 ,而在正常粘膜、单纯增生和轻至中度不典型增生组织中几乎无表达 (P <0 0 5 )。结论　内镜下卢戈液染色和活组织p5 3检测诊断食管早期癌和表浅癌的设想具有可行性。

Combination of lugol's staining and examination of p53 for detecting early esophageal cancer

Objective: To evaluate the feasibility of Lugol's staining combined with expression of p53 oncoproteins in detecting early, superficial esophageal cancer. Methods: Lugol's iodine were sprayed on 97 surgically resected specimens of esophageal cancer, p53 oncoprotein of small areas unstained by Lugol's iodine (larger than 2mm in diameter) were studied immunohistochemically. Results: There were 63 small areas unstained by Lugol's iodine, including 42 dysplasias, 1 carcinoma in situ, and 11 squamous cell carcinomas. p53 expression was more often found in severe dysplasias and carcinomas(45.5%) than in normal mucosa or mild- to- moderate dysplasias (P<0.05). Conclusion: Lugol's iodine staining combined with expression of p53 oncoproteins in detecting early, superficial esophageal cancer by endoscopy seems reasonable.