Tanière P, Martel-Planche G, Maurici D, Lombard-Bohas C, Scoazec J Y, Montesano R, Berger F, Hainaut P
International Agency for Research on Cancer. the Fédération des Spécialités Digestives and the Laboratoire d'Anatomie Pathologique, Hôpital Edouard Herriot, Lyon, France.
Am J Pathol. 2001 Jan;158(1):33-40. doi: 10.1016/S0002-9440(10)63941-7.
Adenocarcinoma of the esophagus (ADCE) with Barrett's mucosa and adenocarcinoma of the cardia (ADCC) are often reported as a single pathological entity. In this study we have used strict anatomical-pathological criteria to distinguish between these two lesions and we have investigated their differences in TP53 mutations, MDM2 gene amplification, and cytokeratin expression. DNA was extracted from the tumor areas of formalin-fixed, paraffin-embedded sections in 26 ADCC and 28 ADCE patients. TP53 mutations were detected by temporal temperature gradient electrophoresis and identified by sequencing. MDM2 amplification was assessed by differential polymerase chain reaction. The expression of cytokeratins 4, 7, and 13 was examined by immunohistochemistry. In ADCC, the male to female ratio was 1.8:1, compared to 27:1 in ADCE. Five ADCC patients had a history of other neoplasms, compared to only one ADCE patient. The two types of tumor differed in the prevalence of TP53 mutations (31% in ADCC and 50% in ADCE) and of MDM2 gene amplification (19% in ADCC and 4% in ADCE), and in the pattern of expression of cytokeratin 7 (positive in 100% of ADCE and in 41% of ADCC) and cytokeratin 13 (positive in 81% of ADCE and in 36.5% of ADCC). ADCE and ADCC differ in their clinical characteristics, in the prevalence of TP53 mutations and MDM2 amplifications, and in the patterns of cytokeratin expression. These results support the notion that ADCC and ADCE are distinct pathological entities.
伴有巴雷特黏膜的食管腺癌（ADCE）和贲门腺癌（ADCC）常被报道为单一病理实体。在本研究中，我们采用严格的解剖病理学标准来区分这两种病变，并研究它们在TP53突变、MDM2基因扩增和细胞角蛋白表达方面的差异。从26例ADCC患者和28例ADCE患者的福尔马林固定、石蜡包埋切片的肿瘤区域提取DNA。通过时间温度梯度电泳检测TP53突变，并通过测序进行鉴定。通过差异聚合酶链反应评估MDM2扩增。采用免疫组织化学检测细胞角蛋白4、7和13的表达。在ADCC中，男女比例为1.8:1，而在ADCE中为27:1。5例ADCC患者有其他肿瘤病史，而ADCE患者只有1例。这两种肿瘤在TP53突变发生率（ADCC中为31%，ADCE中为50%）、MDM2基因扩增发生率（ADCC中为19%，ADCE中为4%）以及细胞角蛋白7（ADCE中100%阳性，ADCC中41%阳性）和细胞角蛋白13（ADCE中81%阳性，ADCC中36.5%阳性）的表达模式上存在差异。ADCE和ADCC在临床特征、TP53突变和MDM2扩增发生率以及细胞角蛋白表达模式方面存在差异。这些结果支持ADCC和ADCE是不同病理实体的观点。
