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目的:研究胃及十二指肠液食管反流对食管内抑癌基因表达的影响及与黏膜损伤的关系。方法:制作单纯胃食管反流(G组)、单纯十二指肠食管反流(D组)、十二指肠胃混合食管反流(DG组)及无反流对照组(C组)动物模型,用免疫组化(SABC法)检测各组不同时期食管上皮p53、p21、p16等基因的表达。结果:反流组食管组织中p53基因表达显著高于C组,并随病程延长而明显增强,胆汁反流组表达又强于胃液反流组;各组不同时期p16表达无明显差异;p21表达D组、DG组较C组为低,且与p53蛋白表达呈负相关。结论:食管内胃及十二指肠反流物均可改变食管上皮p53、p21基因的表达,而十二指肠内容物的作用更明显。这些基因的改变可能参与反流性食管炎及其并发症的发生。
Objective: To study the effect of gastric esophageal reflux and duodenal esophageal reflux on the expression of tumor suppressor gene in esophagus and its relationship with mucosal injury. Methods: Animal models of simple gastroesophageal reflux (G group), simple duodenal esophageal reflux (D group), duodenogastric gastroesophageal reflux (DG group) and no-reflow control group (C group) Immunohistochemistry (SABC method) was used to detect the expression of p53, p21, p16 and other genes in different stages of esophageal epithelial cells. Results: The expression of p53 gene in esophageal tissues of reflux group was significantly higher than that of group C, and was significantly increased with the prolongation of duration. The expression of p16 in reflux group was stronger than that in gastric reflux group. There was no significant difference in p16 expression between different groups Group D and group DG were lower than group C and negatively correlated with p53 protein expression. Conclusion: Both esophageal intragastric and duodenal reflux can change the expression of p53 and p21 in esophageal epithelium, while the content of duodenal contents is more obvious. Changes in these genes may be involved in the occurrence of reflux esophagitis and its complications.