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目的 :探讨河南食管癌高发区居民食管和贲门上皮癌变过程中C erbB2和c myc的表达变化特征及其与病变的关系。方法 :采用纤维内镜活检、组织病理学和免疫组织化学方法 ,对 84例无症状人群食管和贲门粘膜活检组织以及 30例食管鳞癌患者和 30例贲门腺癌患者的癌组织进行C erbB2和c myc的表达变化以及病理学的研究。结果 :5 8例食管粘膜活检组织中 ,共检出 16例正常食管上皮 ,34例基底细胞过度增生 (BCH)和 8例间变(DYS) ;2 6例贲门活检组织中 ,共检出 7例正常 ,6例慢性浅表性胃炎 (CSG) ,10例慢性萎缩性胃炎 (CAG)和 3例DYS。食管正常组织 ,BCH和DYS组织均未发现C erbB2阳性反应 ,但鳞状细胞癌 (SCC)组织C erbB2阳性率为5 0 % ;食管上皮各级病变组织均出现不同程度的c myc阳性反应 ,阳性率随病变进展而明显升高。贲门上皮各级病变组织均出现不同程度的C erbB2和c myc免疫阳性率均出现明显的升高 ,其中间变组织阳性率最高 ,而贲门癌组织中其阳性率略低于间变组织。结论 :c myc过度表达是食管和贲门癌变过程中频发的分子事件 ,并与病变进展密切相关。C erbB2过度表达与贲门上皮癌变密切相关 ,并可能是食管癌变晚期的重要分子事件
OBJECTIVE: To investigate the changes of C erbB2 and c myc in esophageal and cardial epithelial carcinogenesis of high incidence area of esophageal cancer in Henan and their relationship with pathological changes. Methods: Eighty-two patients with asymptomatic esophageal and gastric cardia biopsies, 30 esophageal squamous cell carcinoma patients and 30 patients with cardiac adenocarcinoma were treated by fiberoptic endoscopy, histopathology and immunohistochemistry for C erbB2 and c myc expression changes and pathological studies. Results: Of the 58 esophageal mucosal biopsies, 16 cases of normal esophageal epithelium, 34 cases of basal cell hyperplasia (BCH) and 8 cases of intervertebral disc degeneration (DYS) were detected. Of the 26 cases of cardiac biopsies, 7 Cases of normal, 6 cases of chronic superficial gastritis (CSG), 10 cases of chronic atrophic gastritis (CAG) and 3 cases of DYS. No positive C erbB2 was detected in normal esophageal tissue, BCH and DYS tissues, but the positive rate of C erbB2 in squamous cell carcinoma (SCC) was 50%. The cmyc positive reaction was observed in the diseased tissues at all stages of esophageal epithelium, The positive rate with the progress of the disease was significantly higher. Cardia epithelial lesions at all levels have varying degrees of C erbB2 and c myc immunopositive rates were significantly increased, the highest positive rate of intervariable tissue, while the cardia cancer tissue was slightly lower than the positive rate of the metachronous tissue. Conclusion: The overexpression of c-myc is a frequent molecular event in the carcinogenesis of esophagus and cardia and is closely related to the progression of the disease. C erbB2 overexpression is closely related to gastric cardia cancer and may be an important molecular event in advanced esophageal cancer