CAJ | 학술논문

　　目的通过免疫组化研究CD44及CD44v6在癌前食管及食管鳞状细胞癌中的表达情况，探讨其与食管鳞状细胞癌的关系及临床意义。方法收集潮州市中心医院病理科存档的食管病例蜡块（所有病例术前均未接受放、化疗）。采用免疫组化PV-9000二步法（非生物素）检测癌前食管63例，食管鳞状细胞癌140例。SPSS16.0统计软件分析实验结果。对于各组之间表达情况的数据统计采用多独立样本非参数检验：Kruskal-Wallis H检验；各组中两两比较采用两独立样本非参数检验：Kruskal-Wallis H检验的方法进行比较。结果 CD44及CD44v6在正常的鳞状上皮，只表达于上皮基底层3~5层细胞，随着上皮的增生，表达的细胞层数逐渐增加，在非典型增生的上皮则主要表达于有异型的上皮，而原位癌则几乎表达于上皮的全层。CD44及CD44v6在各种食管癌前病变组织与食管鳞状细胞癌中的表达均存在差异（均P<0.01），其中从正常食管组织及伴上皮增生但无细胞异型的食管组织至食管鳞状细胞癌之间，其表达强度逐渐增强，而从非典型增生及原位癌至食管鳞状细胞癌之间的表达强度逐渐减弱。结论CD44及CD44v6在癌前食管及食管鳞状细胞癌中的表达差异，提示它们可能与食管鳞状细胞癌的发生及发展有关，为食管癌干细胞的进一步研究提供线索。
　　목적통과면역조화연구CD44급CD44v6재암전식관급식관린상세포암중적표체정황，탐토기여식관린상세포암적관계급림상의의。방법수집조주시중심의원병이과존당적식관병례사괴（소유병례술전균미접수방、화료）。채용면역조화PV-9000이보법（비생물소）검측암전식관63례，식관린상세포암140례。SPSS16.0통계연건분석실험결과。대우각조지간표체정황적수거통계채용다독립양본비삼수검험：Kruskal-Wallis H검험；각조중량량비교채용량독립양본비삼수검험：Kruskal-Wallis H검험적방법진행비교。결과 CD44급CD44v6재정상적린상상피，지표체우상피기저층3~5층세포，수착상피적증생，표체적세포층수축점증가，재비전형증생적상피칙주요표체우유이형적상피，이원위암칙궤호표체우상피적전층。CD44급CD44v6재각충식관암전병변조직여식관린상세포암중적표체균존재차이（균P<0.01），기중종정상식관조직급반상피증생단무세포이형적식관조직지식관린상세포암지간，기표체강도축점증강，이종비전형증생급원위암지식관린상세포암지간적표체강도축점감약。결론CD44급CD44v6재암전식관급식관린상세포암중적표체차이，제시타문가능여식관린상세포암적발생급발전유관，위식관암간세포적진일보연구제공선색。
Objective To explore the relationship and clinical significance through investigated the expression of CD44 and CD44v6 in different types of esophageal epithelial hyperplasia and squamous cell carcinoma by immunohistochemical method. Methods Paraffin blocks of esophageal carcinoma were collected from department of Pathology, Chaozhou central hospital. The patients were not treated with chemotherapy or radiotherapy before operation. The expression of CD44 and CD44v6 in 63 cases of esophageal epithelial hyperplasia and 140 cases of esophageal squamous cell carcinoma (ESCC) were detected by immunohistochemistry PV-9000 two-steps methods using monoclonal antibodies. The results were analyzed with SPSS 16.0 statistics software. The difference of expression between each sample in one group was analyzed by multi-independent samples nonparameter tests (Kruskal-Wallis H tests). The difference of expression between two samples in one group was analyzed by 2-independent samples nonparameter tests (Kruskal-Wallis H tests). Results In normal squamous epithelium, only 3~5 layers of cells were positive for CD44 and CD44v6, and the expression of cell layers gradually increased with the epithelial hyperplasia. The atypical hyperplasia epithelium were mainly expressed in atypia epithelial, and almost all epithelial layers expressed in carcinoma in situ. There were significant difference for the expression of CD44 and CD44v6 between normal squamous epithelium and ESCC, the hyperplasia epithelium and ESCC, the atypical hyperplasia epithelium and ESCC, the carcinoma in situ and ESCC (all P<0.01). The expression of CD44 and CD44v6 in ESCC was greater than normal squamous epithelium and hyperplasia epithelium, but it was weaker than atypical hyperplasia epithelium and carcinoma in situ. Conclusion The different expression of CD44 and CD44v6 in different types of esophageal epithelium and ESCC implied that CD44 and CD44v6 may be relate to the occurrence and development of ESCC. They may be the stem cells of ESCC.