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目的探讨食管贲门癌组织中端粒酶活性及p27表达及其临床意义。方法采用PNA原位杂交方法和免疫组化方法,检测110例食管贲门癌及20例正常食管、贲门组织及30例癌旁组织端粒酶活性和p27的表达水平。结果110例食管贲门癌中,90例端粒酶表达呈阳性,阳性率迭81.8%,癌旁组织中5例呈阳性,阳性率4.5%,正常食管、贲门组织中阴性,差异有显著性(P<0.05)。端粒酶表达与肿块大小、淋巴结转移、病理分级和预后显著相关(P<0.05)。样本中51例p27表达呈阳性,阳性率达46.4%,癌旁组织中22例呈阳性,阳性率73.3%,二者间有显著性差异(P<0.05),p27表达与肿块大小、淋巴结转移、病理分级和预后显著相关(P<0.05)。端粒酶活性的表达和p27表达的水平呈负相关。结论食管贲门癌的发生发展及预后与端粒酶活性过度表达和p27表达水平下调有关,二者可作为食管、贲门癌诊断指标。
Objective To investigate the telomerase activity and p27 expression in esophageal and cardiac cancer tissues and their clinical significance. Methods The telomerase activity and p27 expression in 110 esophageal and cardial cancers, 20 normal esophageal and cardiac tissues and 30 adjacent normal tissues were detected by PNA in situ hybridization and immunohistochemistry. Results Among the 110 esophageal and cardia cancers, 90 had telomerase positive, with a positive rate of 81.8% and 5 of paracancerous tissues with a positive rate of 4.5%. The positive rate of telomerase in normal esophagus and cardia was significantly lower than that in normal esophagus P <0.05). Telomerase expression was significantly associated with tumor size, lymph node metastasis, pathological grade and prognosis (P <0.05). The positive expression rate of p27 was 46.4% in 51 samples, while the positive rate was 73.3% in the paracancerous tissues (P <0.05). The expression of p27 was correlated with the size of the tumor and lymph node metastasis , Pathological grade and prognosis were significantly correlated (P <0.05). The expression of telomerase activity was negatively correlated with the level of p27 expression. Conclusion The occurrence, development and prognosis of esophageal and cardial carcinoma are related to the overexpression of telomerase activity and the down-regulation of p27 expression, both of which may serve as the diagnostic indicators for esophageal and cardial carcinoma.