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目的探讨胃黏膜上皮内瘤变组织中环氧合酶(COX)-2蛋白的表达情况及其临床意义。方法采用免疫组织化学技术,检测56例内镜活检病理证实为上皮内瘤变的标本中COX-2蛋白的表达情况。结果(1)经HE染色识别的胃黏膜组织上皮内瘤变56例中轻度不典型增生18例,中度不典型增生18例,重度不典型增生17例,原位癌3例。(2)COX-2蛋白表达在轻度不典型增生、中度不典型增生、重度不典型增生和原位癌的阳性率分别为33.33%(6/18)、50%(9/18)、70.59%(12/17)和100%(3/3),各组间比较差异显著(P<0.05)。高级别上皮内瘤变的阳性表达率(75%)明显高于低级别上皮内瘤变者(41.67%),两者比较差异显著(P<0.01)。结论检测胃黏膜上皮内瘤变组织中COX-2蛋白表达可以帮助临床识别胃黏膜上皮内瘤变组织,预测胃癌前病变的进展,为临床选择治疗方案(ESD、外科手术等)提供依据。
Objective To investigate the expression of cyclooxygenase (COX) -2 protein in gastric intraepithelial neoplasia and its clinical significance. Methods Immunohistochemical technique was used to detect the expression of COX-2 protein in 56 specimens of intraepithelial neoplasia confirmed by endoscopic biopsy. Results (1) The gastric mucosal epithelial neoplasia identified by HE staining in 56 cases of mild dysplasia in 18 cases, moderate dysplasia in 18 cases, severe dysplasia in 17 cases, 3 cases of carcinoma in situ. (2) The positive rates of COX-2 protein expression in mild dysplasia, moderate dysplasia, severe dysplasia and carcinoma in situ were 33.33% (6/18) and 50% (9/18), respectively 70.59% (12/17) and 100% (3/3) respectively. There was significant difference among the groups (P <0.05). The positive rate of high grade intraepithelial neoplasia (75%) was significantly higher than that of low grade intraepithelial neoplasia (41.67%), the difference was significant (P <0.01). Conclusion Detection of COX-2 protein expression in gastric intraepithelial neoplasia can help clinical identification of gastric intraepithelial neoplasia and predict the progression of gastric precancerous lesions, and provide the basis for clinical choice of treatment (ESD, surgery, etc.).