CAJ | 학술논문

目的：比较不同病理类型食管黏膜组织中程序性细胞死亡因子4（PDCD4）表达水平，并探讨其意义。方法88例经临床及内镜下诊断为反流性食管炎。病理活检结果为非肠上皮化生25例（A组）、肠上皮化生25例（ B组）、低级别上皮内瘤变16例（ C组）、高级别上皮内瘤变组12例（ D组）、腺癌10例（ E组）。另取25例消化不良患者的正常食管黏膜组织作为对照组（N组）。用免疫组化法检测A、B、C、D患者病灶或N组患者正常食管黏膜组织中PDCD4。结果 N组PDCD4表达量为10．623±0．202，其中强阳性25例、弱阳性0例、阴性0例；A组分别为10．569±0．128和24、1、0例；B组分别为9．423±0．025和23、2、0例；C组分别为6．051±0．233和10、6、0例；D组分别为0．902±0．201和0、0、12例；E组分别为0．723±0．224和0、0、10例。 PDCD4表达量D组＜C组＜B组＜A组（P均＜0．05），E组与D组、A组与N组相比差异无统计学意义。 PDCD4表达阳性率D、E组均为0，N、A、B、C组均为100％，P＜0．05。结论反流性食管炎进展为食管腺癌过程中，PDCD4表达逐渐下调。检测食管黏膜组织中PDCD4表达水平可能有助于评估反流性食管炎恶性转化潜能。
목적：비교불동병리류형식관점막조직중정서성세포사망인자4（PDCD4）표체수평，병탐토기의의。방법88례경림상급내경하진단위반류성식관염。병리활검결과위비장상피화생25례（A조）、장상피화생25례（ B조）、저급별상피내류변16례（ C조）、고급별상피내류변조12례（ D조）、선암10례（ E조）。령취25례소화불량환자적정상식관점막조직작위대조조（N조）。용면역조화법검측A、B、C、D환자병조혹N조환자정상식관점막조직중PDCD4。결과 N조PDCD4표체량위10．623±0．202，기중강양성25례、약양성0례、음성0례；A조분별위10．569±0．128화24、1、0례；B조분별위9．423±0．025화23、2、0례；C조분별위6．051±0．233화10、6、0례；D조분별위0．902±0．201화0、0、12례；E조분별위0．723±0．224화0、0、10례。 PDCD4표체량D조＜C조＜B조＜A조（P균＜0．05），E조여D조、A조여N조상비차이무통계학의의。 PDCD4표체양성솔D、E조균위0，N、A、B、C조균위100％，P＜0．05。결론반류성식관염진전위식관선암과정중，PDCD4표체축점하조。검측식관점막조직중PDCD4표체수평가능유조우평고반류성식관염악성전화잠능。
Objective To compare the expression of programmed cell death factor 4 ( PDCD4) in different pathologi-cal types of esophageal mucosa,and to explore its significance.Methods A total 88 patients with reflux esophagitis by en-doscopic diagnosis.These patients were grouping as follows:non-intestinal columnar metaplasia(25 cases,A group),intes-tinal metaplasia(25cases,B group), low-grade intraepithelial neoplasia(16cases,C group),high-grade intraepithelial neo-plasia(12cases,D group),adenocarcinoma(10cases,E group).As controls, 25 additional samples of native esophageal mucosa were obtained from patients with dyspepsia(25,N group) .Immunohistochemical method was used to detect the ex-pression of PDCD4 in lesions and in normal esophageal mucosa tissues in these patients.Results The PDCD4 protein ex-pression had no obvious difference in male and female groups, while, in age group in the comparison, the elderly group than young group expressed less PDCD4, and in these specimens from patients with pathological types at different levels, PDCD4 expression clearly cut with the increase of the severity of pathological trend.Conclusions The expression of PD-CD4 gradually reduced in the process from reflux esophagitis to esophageal adenocarcinoma.And it may be helpful in evalu-ating the reflux esophagitis malignant transformation potential by testing PDCD4 expression in esophageal mucosa.