CAJ | 학술논문

目的：分析上消化道双原发癌中Her-2蛋白表达和人乳头瘤病毒（HPV）感染情况与临床病理因素的关系，探讨同一系统中不同组织类型的恶性肿瘤在发生发展过程中的联系。方法39例患者均为原发性食管鳞状细胞癌、胃／贲门腺癌。采用免疫组织化学法检测双原发癌标本中Her-2蛋白的表达，采用原位杂交技术检测HPV-DNA表达情况。结果 Her-2蛋白在食管鳞状细胞癌的过表达与鳞状细胞癌分化程度、浸润深度、淋巴结转移及患者的年龄、性别均无关（P＞0.05），Her-2在胃腺癌的过表达与腺癌浸润深度、淋巴结转移相关（P＜0.05），与患者的年龄、性别、分化程度无关（P＞0.05）。食管鳞状细胞癌和胃腺癌患者HPV感染与二者的肿瘤分化程度、浸润深度、淋巴结转移、患者的年龄、性别均无关（P＞0.05）。在上消化道双原发癌肿瘤组织中，Her-2蛋白的过表达呈一致性（κ＝0.75，P＜0.05）。同时， HPV-DNA的表达也呈一致性（κ＝0.80，P＜0.05）。结论 Her-2蛋白和HPV在上消化道双原发癌中均存在一定的一致性表达，可能是食管鳞状细胞癌和胃腺癌的共同相关致病危险因素。
목적：분석상소화도쌍원발암중Her-2단백표체화인유두류병독（HPV）감염정황여림상병리인소적관계，탐토동일계통중불동조직류형적악성종류재발생발전과정중적련계。방법39례환자균위원발성식관린상세포암、위／분문선암。채용면역조직화학법검측쌍원발암표본중Her-2단백적표체，채용원위잡교기술검측HPV-DNA표체정황。결과 Her-2단백재식관린상세포암적과표체여린상세포암분화정도、침윤심도、림파결전이급환자적년령、성별균무관（P＞0.05），Her-2재위선암적과표체여선암침윤심도、림파결전이상관（P＜0.05），여환자적년령、성별、분화정도무관（P＞0.05）。식관린상세포암화위선암환자HPV감염여이자적종류분화정도、침윤심도、림파결전이、환자적년령、성별균무관（P＞0.05）。재상소화도쌍원발암종류조직중，Her-2단백적과표체정일치성（κ＝0.75，P＜0.05）。동시， HPV-DNA적표체야정일치성（κ＝0.80，P＜0.05）。결론 Her-2단백화HPV재상소화도쌍원발암중균존재일정적일치성표체，가능시식관린상세포암화위선암적공동상관치병위험인소。
Objective To analyze the relationship between expression of Her-2 protein and the infection of human papillomavirus (HPV) and clinicopathological features in upper gastrointestinal multiple primary cancers, and to explore the relationship between the different histological malignancies in a single-system. Methods 39 patients were primary esophageal squamous cell carcinoma and gastric/cardia adenocarcinoma. By using immunohistochemistry (IHC) methods, the expression of Her-2 protein in 39 cases of multiple primary cancers specimens were examined, and by using insitu hybridization (ISH) technology, the infection of HPV in the same ones were detected. Results The over-expression of Her-2 protein in esophageal squamous cell carcinoma was not significantly relative to the degree of differentiation, the depth of penetration, the lymph node metastasis and the patientsˊage and gender (P> 0.05). The over-expression of Her-2 protein in gastric adenocarcinoma was closely correlated to the invasion depth and lymph node metastasis (P<0.05), no obvious correlation with the factors of patientsˊage and gender and the degree of differentiation (P > 0.05). The infection of HPV in esophageal squamous cell carcinoma and gastric adenocarcinoma was not significantly relative to the degree of differentiation, the depth of penetration,the lymph node metastasis, and the age and gender of the patients (P> 0.05). In the upper gastrointestinal multiple primary cancers, the Her-2 protein over-expression had the consistency (κ= 0.56, P< 0.05). Meanwhile, the HPV-DNA expression also had the consistency (κ=0.80, P<0.05). Conclusion Both Her-2 protein and HPV expression show the consistency in upper gastrointestinal multiple primary cancers,which suggests that Her-2 protein and HPV may be the common oncogenic factors for both esophageal squamous cell carcinoma and gastric adenocarcinoma.