CAJ | 학술논문

目的：探讨内镜碘染色与P63蛋白对早期食管癌的诊断研究。方法对我院可疑食管病变的180例患者随机分为实验组和对照组各90例，实验组用碘溶液对食管黏膜进行染色，并对不染色、淡染色、深染色区进行病理活检；对照组凭内镜医生经验对可疑病变行病理活检；用免疫组化检测所有活检组织P63蛋白的表达。结果实验组病理诊断早期食管癌10例（11.1%），重度不典型增生16例（17.7%）；对照组病理诊断早期食管癌4例（4.4%），重度不典型增生5例（5.6%）；两组早期食管癌及其癌前病变的诊断率差异有统计学意义（P＜0.05）。所有125例活检组织中，P63阳性表达36例（28.8%），而11例鳞状细胞癌P63蛋白均有表达（100%），21例重度不典型增生P63阳性表达18例（85.7%），85例正常及轻-中度不典型增生P63阳性表达仅2例（2.4%），P63在食管鳞状细胞癌及重度不典型增生显著高表达。结论通过内镜下碘染色进行初步筛查，对活检组织行P63蛋白检测，可以提高早期食管癌的诊断率。
목적：탐토내경전염색여P63단백대조기식관암적진단연구。방법대아원가의식관병변적180례환자수궤분위실험조화대조조각90례，실험조용전용액대식관점막진행염색，병대불염색、담염색、심염색구진행병리활검；대조조빙내경의생경험대가의병변행병리활검；용면역조화검측소유활검조직P63단백적표체。결과실험조병리진단조기식관암10례（11.1%），중도불전형증생16례（17.7%）；대조조병리진단조기식관암4례（4.4%），중도불전형증생5례（5.6%）；량조조기식관암급기암전병변적진단솔차이유통계학의의（P＜0.05）。소유125례활검조직중，P63양성표체36례（28.8%），이11례린상세포암P63단백균유표체（100%），21례중도불전형증생P63양성표체18례（85.7%），85례정상급경-중도불전형증생P63양성표체부2례（2.4%），P63재식관린상세포암급중도불전형증생현저고표체。결론통과내경하전염색진행초보사사，대활검조직행P63단백검측，가이제고조기식관암적진단솔。
Objective To explore diagnostic study of endoscopic iodine staining and P63 protein on early esophageal cancer.Methods 180 patients with suspected esophageal lesions in our hospital were randomly allocated to into the experimental group and the control group,with 90 in each. Esophageal mucosa was dyed by iodine solution in the experimental group.In addition,unstained areas,lightly stained areas and deeply stained areas were received pathologic biopsy.In the control group,suspected lesions were received pathologic biopsy according to Endoscope and doctor's experience.Expression of biopsy tissues P63 proteins was detected in immunohistochemical detection. Results10 patients with early esophageal cancer and 16 with severe atypical hyperplasia are in the experimental group according to pathological diagnosis which accounting for 11.1% and 17.7% respectively.4 patients with early esophageal cancer and 5 with severe atypical hyperplasia are in the the control group according to pathological diagnosis which accounting for 4.4% and 5.6% respectively.Differences of diagnostic rates of early esophageal cancer and precancerous lesions in two groups have statistically significance (P<0.05).Of all 125 biopsy tissues,36 are positive expression of P63 accounting for 28.8% and P63 proteins of 11 with squamous cell carcinoma all have expression accounting for 100%. 18 are positive expression of P63 in 21 with severe atypical hyperplasia which accounts for 85.7%.Only 2 are positive expression of P63 in 85 with normal,light-moderate atypical hyperplasia accounting for 2.4%.Significantly high expression of P63 was in patients with esophageal squamous cell carcinoma and severe atypical hyperplasia.Conclusion Preliminary screening through endoscopic iodine staining and detection of biopsy tissues P63 proteins can improve the diagnostic rate of early esophageal cancer.