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目的：通过对食管和贲门癌原发病灶和淋巴结转移病灶肿瘤抑制基因ｐ５３变化规律的研究，加深对食管和贲门癌转移发生的分子学基础的了解。方法：采用组织病理学和免疫组织化学（ＡＢＣ）方法，对３１例手术切除的食管和贲门癌原发病灶和转移病灶肿瘤抑制基因ｐ５３蛋白聚集进行比较研究。结果：３１例手术标本中，病理检查发现２４例食管鳞状细胞癌，７例为贲门腺癌。研究表明：２４例食管原发和转移鳞癌中，１１例原发和转移病灶中均出现ｐ５３蛋白聚集的变化，原发和转移病灶的一致性变化发生率为６１％（１１／１８）；在６例原发病灶ｐ５３免疫组化阴性患者中，其淋巴结转移病灶也同时出现免疫阴性反应。在７例胃贲门腺癌中，３例原发和转移病灶同时出现ｐ５３免疫阳性表达的一致率为５０％（３／６）；１例原发病灶ｐ５３免疫组化阴性患者，其淋巴结转移病灶也出现阴性反应。结论：肿瘤抑制基因ｐ５３在食管和贲门癌癌变和转移中起一定的作用。可能是食管和贲门癌侵袭与转移过程中值得重视的生物学指标之一。
OBJECTIVE: To study the changes of tumor suppressor gene p53 in primary lesions of esophageal and cardiac cancers and lymph node metastases, and to deepen understanding of the molecular basis of esophageal and cardiac cancer metastasis. Methods: The histopathological and immunohistochemical (ABC) methods were used to compare the tumor suppressor gene p53 protein accumulation in the primary and metastatic lesions of 31 esophageal and cardiac cancers. RESULTS: Of the 31 surgical specimens, pathological examination revealed 24 cases of esophageal squamous cell carcinoma and 7 cases of cardial adenocarcinoma. Studies have shown that in 24 cases of primary and metastatic squamous cell carcinoma of the esophagus, aggregation of p53 protein was observed in 11 cases of primary and metastatic squamous cell carcinoma. The coincidence rate of primary and metastatic lesions was 61% (11/18). In 6 patients with primary lesions with p53 immunohistochemistry negative, their lymph node metastases also showed an immunonegative response. In 7 cases of gastric cardia adenocarcinoma, the coincident rate of simultaneous expression of p53 immunoreactivity in 3 cases of primary and metastatic lesions was 50% (3/6); in 1 case of p53 immunohistochemically negative patients with primary lesion, their lymph node metastasis lesions Negative reactions also occur. Conclusion: The tumor suppressor gene p53 plays a role in the carcinogenesis and metastasis of esophageal and cardiac cancers. It may be one of the important biological indicators in the invasion and metastasis of esophageal and cardiac cancers.