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目的：探讨食管癌变过程中肿瘤抑制基因ｐ５３和癌基因ｃ－ｍｙｃ、ｂｃｌ－２的变化及其与细胞凋亡的关系。方法：采用免疫组化法（ＡＢＣ）检测２７９例食管粘膜活检组织中ｐ５３、ｃ－ｍｙｃ、ｂｃｌ－２的表达以及细胞凋亡的变化。结果：从食管正常上皮到基底细胞增生、间变和癌，ｐ５３、ｃ－ｍｙｃ、ｂｃｌ－２免疫阳性表达率及细胞凋亡发生率和细胞凋亡指数（ＡＩ）均呈升高趋势，而且在同一阶段病变，ｐ５３和ｃ－ｍｙｃ阳性表达时凋亡指数高于其阴性表达，而ｂｃｌ－２阳性表达时凋亡指数低于其阴性表达。结论：在食管癌变过程中可能有多种肿瘤抑制基因和癌基因参与，细胞凋亡在食管癌变过程中可能有重要的生物学意义。
Objective: To investigate the relationship between tumor suppressor gene p53, oncogene c-myc, bcl-2 and apoptosis in esophageal carcinogenesis. Methods: Immunohistochemical method (ABC) was used to detect the expression of p53, c-myc, bcl-2 and apoptosis in 279 cases of esophageal mucosa biopsy. RESULTS: From esophageal normal epithelium to basal cell hyperplasia, metastasis, and carcinoma, the positive rates of p53, c-myc, bcl-2 immunoreactivity, apoptosis, and apoptosis index (AI) both increased. At the same stage of lesions, the apoptotic index was higher than that of negative expression when p53 and c-myc were positively expressed, while the apoptosis index was lower than that of negative expression when bcl-2 was positively expressed. Conclusion: There may be many tumor suppressor genes and oncogenes involved in the process of esophageal carcinogenesis. Apoptosis may have important biological significance in the process of esophageal carcinogenesis.