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目的探讨Barrett食管(Barrett’s esophagus,BE)患者病变组织中p53、COX-2基因表达与TNF-α、NF-κB水平的关系。方法选取2016年3月—2017年3月确诊的BE患者19例,SSBE 13例(SSBE组)、LSBE 6例(LSBE组),另选食管正常者20例作为对照组。应用荧光定量PCR法检测各组食管组织中p53、COX-2 mRNA表达,ELISA法检测组织TNF-α、NF-κB水平。计量资料多组间比较采用单因素方差分析,两两比较采用LSD-t检验。采用Pearson相关分析变量间关系。P<0.05为差异有统计学意义。结果对照组、SSBE组、LSBE组p53 mRNA相对表达量分别为1.00±0.33、2.77±0.41、3.54±0.45,COX-2 mRNA相对表达量分别为1.00±0.28、2.33±0.25、3.78±0.32,TNF-α水平分别为(23.15±4.41、65.78±5.32、87.94±4.83)pg/ml,NF-κB水平分别为(18.52±8.41、52.71±10.25、76.45±9.36)pg/ml。SSBE组、LSBE组p53、COX-2 mRNA相对表达量及TNF-α、NF-κB水平均高于对照组(均P<0.05),LSBE组COX-2 mRNA相对表达量及TNF-α、NF-κB水平高于SSBE组(均P<0.05),但两组p53相对表达量比较差异无统计学意义(P>0.05)。Pearson相关分析显示,SSBE组、LSBE组p53 mRNA相对表达量与COX-2 mRNA相对表达量及NF-κB、TNF-α水平均呈正相关(r=0.623、0.601、0.502;0.701、0.589、0.536,均P<0.05),COX-2 mRNA相对表达量与NF-κB水平呈正相关(r=0.453、0.583,均P<0.05),而与TNF-α水平无相关性(r=0.253、0.329,均P>0.05)。结论p53、COX-2、TNF-α、NF-κB共同介导的炎症反应可能在BE的发生发展中起重要作用,联合检测有助于BE的早期诊断、治疗及评估预后。
Objective To investigate the relationship between the expression of p53 and COX-2 gene and the level of TNF-α and NF-κB in patients with Barrett’s esophagus (BE). Methods Nineteen patients with BE, 13 patients with SSBE (SSBE), 6 patients with LSBE (LSBE) and 20 patients with normal esophagus were selected as the control group from March 2016 to March 2017. The expressions of p53 and COX-2 mRNA in esophageal tissues were detected by real-time fluorescence quantitative PCR. The levels of TNF-α and NF-κB were detected by ELISA. Measurement data were compared between groups using one-way ANOVA, pairwise comparison using LSD-t test. Pearson correlation analysis of the relationship between variables. P <0.05 for the difference was statistically significant. Results The relative expression levels of p53 mRNA in control group, SSBE group and LSBE group were 1.00 ± 0.33, 2.77 ± 0.41 and 3.54 ± 0.45, respectively. The relative expressions of COX-2 mRNA were 1.00 ± 0.28, 2.33 ± 0.25, 3.78 ± 0.32, -α were (23.15 ± 4.41,65.78 ± 5.32,87.94 ± 4.83) pg / ml and NF-κB levels were (18.52 ± 8.41,52.71 ± 10.25,76.45 ± 9.36) pg / ml, respectively. The relative expression of COX-2 mRNA and the level of TNF-α and NF-κB in SSBE and LSBE groups were significantly higher than those in control group (all P <0.05) (P <0.05). However, there was no significant difference in the relative expression of p53 between the two groups (P> 0.05). Pearson correlation analysis showed that the relative expression of p53 mRNA in SSBE group and LSBE group was positively correlated with the relative expression of COX-2 mRNA and the levels of NF-κB and TNF-α (r = 0.623,0.601,0.502; 0.701,0.589,0.536, (All P <0.05). The relative expression of COX-2 mRNA was positively correlated with the level of NF-κB (r = 0.453,0.583, all P <0.05), but not with the level of TNF- P> 0.05). Conclusions The inflammatory reaction mediated by p53, COX-2, TNF-α and NF-κB may play an important role in the occurrence and development of BE. Combined detection may be helpful for the early diagnosis, treatment and prognosis of BE.