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目的观察Ser139磷酸化的组蛋白H2AX(γ-H2AX)与ki-67在Barrett食管及食管腺癌中的表达及其临床意义,探讨其在临床中的意义。方法选择2001年1月—2016年12月在解放军第159医院病理科保存的食管腺癌病理切片116例,为食管腺癌组;选择同期诊断为Barrett食管的45例为Barrett食管组;选择正常食管黏膜30例作为正常食管组。用免疫组织化学的方法检测各组标本γ-H2AX和ki-67的表达,比较各组的差异,分析γ-H2AX和ki-67水平与食管腺癌临床病理特征的关系。结果食管腺癌组、Barrett食管组和正常食管组γ-H2AX阳性率分别为68.10%、33.33%和10.00%,ki-67阳性率分别为84.48%、62.22%和13.33%,食管腺癌组和Barrett食管组明显高于正常食管组(P<0.01);食管腺癌组明显高于Barrett食管组(P<0.01);γ-H2AX和ki-67阳性表达率与食管腺癌患者性别、年龄、肿瘤部位和浸润深度无明显的相关性(P>0.05);而与肿瘤大小、分化程度、淋巴结转移和TNM分期具有明显相关性(P<0.01);食管腺癌组织中的γ-H2AX和ki-67表达呈正相关(r=0.524,P<0.01)。结论γ-H2AX与ki-67参与了食管腺癌的发生发展过程,对食管癌的增殖、转移和恶性作用具有明显提示作用,可以作为食管癌早期诊断和食管癌进展的潜在预测指标。
Objective To investigate the expression and clinical significance of Ser139-phosphorylated histone H2AX (γ-H2AX) and ki-67 in Barrett’s esophagus and esophageal adenocarcinoma and to explore their clinical significance. Methods 116 cases of esophageal adenocarcinoma preserved in the Department of Pathology, the 159th Hospital of PLA from January 2001 to December 2016 were selected as the esophageal adenocarcinoma group. Forty-five patients with Barrett’s esophagus diagnosed during the same period were selected as the normal Barrett’s esophagus. Esophageal mucosa in 30 cases as a normal esophageal group. The expressions of γ-H2AX and ki-67 in each group were detected by immunohistochemistry. The differences between groups were analyzed. The relationship between γ-H2AX and ki-67 levels and the clinicopathological features of esophageal adenocarcinoma was analyzed. Results The positive rates of γ-H2AX in esophageal adenocarcinoma, Barrett’s esophagus and normal esophagus were 68.10%, 33.33% and 10.00%, respectively. The positive rates of ki-67 were 84.48%, 62.22% and 13.33% The positive rates of γ-H2AX and ki-67 in esophageal adenocarcinoma group were significantly higher than those in Barrett esophagus group (P <0.01) There was no significant correlation between tumor location and invasive depth (P> 0.05), but significant correlation with tumor size, differentiation degree, lymph node metastasis and TNM staging (P <0.01); γ-H2AX and ki -67 expression was positively correlated (r = 0.524, P <0.01). Conclusions γ-H2AX and ki-67 are involved in the development and progression of esophageal adenocarcinoma, which may have significant implications for the proliferation, metastasis and malignancy of esophageal cancer, which may serve as potential predictors for the early diagnosis of esophageal cancer and esophageal cancer progression.