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目的探讨Barrett食管(BE)发生并进展到食管腺癌(EA)过程中细胞凋亡及凋亡相关蛋白bcl-2表达的变化规律及意义。方法采用细胞凋亡原位检测技术(TUNEL法)和免疫组化法检测正常食管黏膜、Barrett食管上皮和食管腺癌3组标本细胞凋亡及bcl-2的表达情况,并进行组间比较和相关分析。结果EA的凋亡指数(AI)低于BE和正常食管上皮(P<0.01);bcl-2蛋白在正常食管黏膜、BE及EA中的表达呈升高趋势(r=0.406,P<0.01);在BE与EA中,bcl-2蛋白表达与细胞凋亡呈负相关(r=-0.507,P<0.01)。结论BE发生并向EA发展过程中,凋亡抑制机制可能起重要作用,而bcl-2可能通过抑制细胞凋亡参与BE及EA的发生发展。
Objective To investigate the regularity of apoptosis and the expression of bcl-2 in Barrett’s esophagus (BE) and its progression to esophageal adenocarcinoma (EA). Methods TUNEL and immunohistochemistry were used to detect the apoptosis and the expression of bcl-2 in normal esophageal mucosa, Barrett’s esophageal epithelium and esophageal adenocarcinoma, and compared between two groups related analysis. Results The apoptotic index (AI) of EA was lower than that of BE and normal esophageal epithelium (P <0.01). The expression of bcl-2 protein in normal esophageal mucosa, BE and EA showed an increasing trend (r = 0.406, In BE and EA, the expression of bcl-2 protein was negatively correlated with apoptosis (r = -0.507, P <0.01). Conclusions BE may play an important role in the development of EA. Inhibition of apoptosis may be involved in the development and progression of BE and EA.