摘要
目的探讨食管癌贲门癌术后胃管或食管返流与食管黏膜换氧化酶-2(COX-2)和同源型盒转录因子2(CDX2)表达的相关性。方法术后分别于不同时间段对35例食管癌和贲门癌患者进行全天氢离子浓度指数(pH)和胆红素监测,另外进行电子胃镜,免疫组织学检查,分析COX-2和CDX2的检测结果,针对胃食管返流患者,采用仪器测量的方式,通过计算得出分数(DeMeester评分)。结果术后返流性食管炎发生率及DeMeester评分随时间延长逐渐升高(P<0.05)。COX-2、CDX2在正常食管黏膜基底细胞内不表达或呈弱阳性表达;术后参与食管黏膜呈阳性表达。Barrett食管化生上皮细胞胞浆内的COX-2、CDX2表达水平呈强阳性。残余食管黏膜发生返流性食管炎的患者CDX2水平显著高于未发生食管炎者,有无发生返流性食管炎的患者COX-2的表达水平差异无统计学意义(P>0.05)。结论食管癌贲门癌术后酸返流同返流性食管炎的发生率随着时间的延长而增加;食管黏膜上的COX-2、CDX2表达是胃食管返流发生的早期变化,同时二者持续呈阳性表达可以作为胃食管返流发生的分子标记,为临床治疗提供参考。
Objective To explore the correlation of cyclooxygenase-2 （COX-2） in the esophageal mucosa and caudal type homeobox transcription factor 2 （CDX2） with changes of gastroesophageal reflux after resection of esophageal and cardiac carcinoma.Methods Hydrogen ion concentration （pH） and bilirubin were monitored in 35 patients with esophageal and cardia carcinoma in different time periods after surgery.In addition,electronic gastroscopy and immune histological examination were conducted to analyze COX-2 and CDX-2 test results.With the method of instrument measurement,DeMeester score was calculated for patients with gastroesophageal reflux.Results The incidence of postoperative reflux esophagitis and DeMeester score were increased with the extension of time （P＜0.05）.COX-2 and CDX2 were not expressed or showed weakly positive expression in normal esophageal mucosa basal cells,with positive expression in esophageal mucosa postoperatively.In Barrett＇s esophagus,the cytoplasm of epithelial cells showed strong positive expression of COX-2,CDX2.CDX2 levels in patients with reflux esophagitis in residual esophageal mucosa were significantly higher than those without reflux esophagitis,with no statistically significant difference in COX-2 expression level between the patients with or without reflux esophagitis （P＞0.05）.Conclusion The incidence of gastroesophageal reflux and reflux esophagitis after resection of esophageal and cardiac carcinoma increases with the extension of time.The expression of COX-2 and CDX2 in esophageal mucosa indicates the early changes of gastroesophageal reflux,and the continuous positive expression of the two indicators can be used as molecular marker to provide reference for clinical treatment.
出处
《海南医学》
CAS
2014年第2期183-185,共3页
Hainan Medical Journal
作者简介
通讯作者：黎仕兴。E—mail：4600231sx@163．com
