Kimura H, Konishi K, Kaji M, Maeda K, Yabushita K, Miwa A
Department of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan.
Hepatogastroenterology. 2001 Nov-Dec;48(42):1662-4.
Barrett's esophagus is a condition in which the stratified squamous epithelium of the esophagus is replaced by a columnar epithelium with malignant potential. Mutations of the tumor-suppressor gene p53 have been implicated in the evolution of esophageal carcinomas. The aim of this study was to determine whether p53 immunoreactivity in Barrett's esophagus is a marker of neoplasia and, if so, when it occurs in the metaplasia-dysplasia-carcinoma sequence. We treated a patient with esophageal carcinoma arising from the Barrett's esophagus. Consecutive evidence existed for a metaplasia-dysplasia-carcinoma in the same specimen. Immunohistochemical staining with the monoclonal antibody was used to detect the intranuclear protein product of mutated p53. No p53 immunoreactivity was seen in specimen of Barrett's mucosa. p53 immunoreactivity was found only in specimen of dysplasia and carcinoma. Immunoreactivity occurs late in the metaplasia-dysplasia-carcinoma sequence, during the transition to high-grade dysplasia.
巴雷特食管是一种食管的复层鳞状上皮被具有恶变潜能的柱状上皮取代的病症。肿瘤抑制基因p53的突变与食管癌的发生发展有关。本研究的目的是确定巴雷特食管中p53免疫反应性是否为肿瘤形成的标志物，如果是，它在化生-发育异常-癌序列中何时出现。我们治疗了一名由巴雷特食管引发的食管癌患者。在同一标本中存在化生-发育异常-癌的连续证据。使用单克隆抗体进行免疫组织化学染色以检测突变型p53的核内蛋白产物。在巴雷特黏膜标本中未见到p53免疫反应性。仅在发育异常和癌的标本中发现p53免疫反应性。免疫反应性在化生-发育异常-癌序列中出现较晚，发生在向高级别发育异常转变的过程中。
