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目的 :探讨贲门癌高、低发区人群贲门癌变过程中MUC3表达变化特征及其与病变发生发展的关系。方法 :采用免疫组织化学 (ABC)法和组织病理学方法 ,对来自河南省贲门癌高发区 6 3例、低发区 10 3例无症状居民贲门粘膜活检组织和高发区 70例、低发区 39例贲门癌 (GCA)手术切除组织的MUC3的表达进行分析。结果 :贲门癌高、低发区居民贲门上皮各级病变 ,均有不同程度的MUC3蛋白表达 ,从慢性浅表性贲门炎 (CSG)→慢性萎缩性贲门炎 (CAG)→不典型增生 (DYS)→贲门癌 (GCA) ,MUC3蛋白表达免疫阳性率高发区分别为 13%、4 4 %、2 9%和38% ,低发区分别为 13%、13%、5 0 %和 33%。结论 :低发区人群贲门癌变演进过程中MUC3阳性表达率呈逐渐升高的趋势 ,DYS阶段的变化最明显 ,而高发区居民CAG阶段阳性率最高 ,提示 2者可能存在不同的危险因素和发病机制。
Objective: To investigate the changes of MUC3 expression and the relationship with the occurrence and development of gastric cardia in the patients with gastric cardia cancer of high and low incidence areas. Methods: Immunohistochemistry (ABC) and histopathological methods were used to analyze the biopsy of cardia mucosa from 70 cases of asymptomatic cardia in 70 low incidence areas and 70 high incidence areas of cardia cancer in Henan Province, The expression of MUC3 in 39 cases of cardiac cancer (GCA) resected tissue was analyzed. Results: There were different degrees of MUC3 protein expression in the patients with cardia carcinoma in the high and low prevalence areas, ranging from chronic superficial cardia (CSG) → chronic atrophic cardia (CAG) to atypical hyperplasia ) → GCA and MUC3 were 13%, 44%, 29% and 38% respectively in the high incidence area, and 13%, 13%, 50% and 33% in the low incidence area respectively. Conclusions: The MUC3 positive expression rate of gastric cardia carcinoma in the low incidence area is gradually increased, the most obvious changes in DYS stage, while the highest positive rate of CAG stage residents, suggesting that there may be different risk factors and incidence of the two mechanism.