Ki-67在Barrett食管、重度反流性食管炎和食管腺癌中的表达和意义

背景：Barrett食管是一种食管腺癌癌前病变。Ki-67是一种能较准确地评估细胞增殖状态的抗原，在肿瘤进程中可能起重要作用。目的：研究Ki-67在Barrett食管、重度反流性食管炎和食管腺癌中的表达和意义。方法：应用免疫组化SP法测定59例Barrett食管、5例重度反流性食管炎、5例食管腺癌和10例正常食管黏膜组织中Ki-67的表达。结果：Ki-67在重度反流性食管炎中的阳性率为80．0％，Barrett食管阳性率为76．3％，与正常食管黏膜组织（20．0％）相比有显著差异（P〈0．05）：食管腺癌阳性率为100％。Ki-67的表达随Barrett食管肠化生程度的加重而增高（P〈0．05）；而不同长度（短段、长段）、肠化生黏膜形态（全周型、舌型和岛型）以及不同程度（轻度、中度）异型增生的Barrett食管，Ki-67的表达均无显著差异（P〉0．05）。结论：Ki-67在重度反流性食管炎和Barrett食管中表达增强，提示其在食管腺癌进程中起重要作用。

Expression of Ki-67 and its Significance in Barrett's Esophagus, Severe Reflux Esophagitis and Esophageal Adenocarcinoma

Background: Barrett's esophagus is a precancerous lesion of esophageal adenocarcinoma. Ki-67 is an antigen which can be used to estimate the process of cell proliferation and may play an important role in the course of development of cancer. Aims: To investigate the expression of Ki-67 and its significance in Barrett's esophagus, severe reflux esophagitis and esophageal adenocarcinoma. Methods: Expression of Ki-67 was determined in 59 cases of Barrett's esophagus, 5 severe reflux esophagitis, 5 esophageal adenocarcinoma, and 10 normal esophageal epithelium by immunohistochemical staining (SP method). Results: Expression of Ki-67 was positive in 80.0% of severe reflux esophagitis and 76.3% of Barrett's esophagus, significantly higher than that in normal esophageal epithelium (20.0%, P<0.05). In esophageal adenocarcinoma, the expression of Ki-67 was positive in 100% of cases. The expression of Ki-67 increased with increase of the degree of intestinal metaplasia in Barrett's esophagus (P<0.05), however, its expression was not significantly different between different length (short-segment and long-segment), types of Barrett's esophagus (circumferential, tongue and island types) and different degrees of dysplasia (low or moderate degree) (P>0.05). Conclusions: Expression of Ki-67 increases in severe reflux esophagitis and Barrett's esophagus, and may play an important role in the course of development of esophageal adenocarcinoma.