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目的 探讨增殖细胞核抗原 (PCNA)和p5 3在反流性食管炎 (RE)及治疗干预后内镜下恢复正常的食管上皮的表达及其意义。方法 2 13例RE及 2 6例治疗后内镜下恢复正常的食管上皮活检标本 ,组织病理学HE染色 ,并采用卵白素 生物素 过氧化物酶复合物法测定PCNA和p5 3的表达。结果 随着食管黏膜从正常到RE和非典型增生 ,PCNA阳性细胞数分别为 (192± 12 0 ) /mm2 、(32 6± 2 0 0 ) /mm2 、(5 96± 2 0 8) /mm2 ,各组之间差异有显著性 (P <0 0 1) ;p5 3阳性表达率逐渐升高 ,分别为5 9%、34 4 %、5 7 6 %,各组之间差异有显著性 (P <0 0 1)。 2 6例RE病人经干预治疗后内镜下食管黏膜形态恢复正常 ,其食管黏膜的PCNA阳性细胞数为 (30 6± 2 14) /mm2 ,p5 3阳性率为 2 6 9%,均较干预前的 (4 83± 2 18) /mm2 和 6 1 5 %明显降低 (P <0 0 1) ;但仍然高于正常对照组 (P <0 0 1)。结论 随食管反流性病变的加重 ,PCNA及p5 3蛋白的表达增加 ;RE患者经干预治疗后内镜下恢复正常者 ,其食管黏膜在分子水平尚未达到正常 ,故仍需维持治疗和内镜随访。
Objective To investigate the expression and clinical significance of proliferating cell nuclear antigen (PCNA) and p5 3 in esophageal epithelium restored to normal after reflux esophagitis (RE) and therapeutic intervention. Method 2 13 cases of RE and 26 cases of endoscopic esophageal epithelial biopsy specimens returned to normal after histopathological HE staining, and the determination of PCNA and p5 3 using avidin biotin peroxidase complex method. Results With the esophageal mucosa from normal to RE and atypical hyperplasia, the number of PCNA positive cells were (192 ± 12 0) / mm2, (32 6 ± 2 0 0) / mm2, (596 ± 2 0 8) / mm2 (P <0.01). The positive expression rate of p5 3 gradually increased (59%, 34 4% and 57 6% respectively), and there was a significant difference among the groups P <0 0 1). The morphology of esophageal mucosa in 26 cases of RE patients returned to normal after endoscopic intervention. The number of PCNA positive cells in esophageal mucosa was (30 6 ± 2 14) / mm 2 and the positive rate of p 5 3 was 26 9% (4 83 ± 2 18) / mm 2 and 61 5% (P 0 01), but still higher than that of the normal control group (P 0 01). Conclusions The expression of PCNA and p53 protein increases with the increase of esophageal reflux disease. In patients with RE, the endoscopic recovery is normal and the esophageal mucosa has not reached the normal level at the molecular level. Therefore, treatment and endoscopic treatment are still required Follow-up.