Yamamoto Soichiro, Kijima Hiroshi, Hara Tadashi, Chino Osamu, Shimada Hideo, Tanaka Makiko, Inokuchi Sadaki, Makuuchi Hiroyasu
Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Int J Mol Med. 2005 Sep;16(3):375-80.
Barrett's esophagus is a premalignant condition associated with gastroesophageal reflux disease, and consists of mucosa with a metaplastic columnar epithelium (specialized columnar epithelium). In this study, we examined the expression of mucin and the Ki-67 labeling index (LI) in 15 cases of esophageal Barrett's adenocarcinoma, and clarified the significance of incomplete intestinal metaplasia of Barrett's mucosa as a premalignant lesion. Gastric mucin (MUC5AC, HGM, and/or MUC6) was detected in 93.3% of the adenocarcinomas, while MUC2 and CD10 (markers of intestinal phenotypes) were detected in 73.3% and 46.2%, respectively. The Ki-67 LI was 34.1% in Barrett's adenocarcinoma. In all cases, gastric mucin was found in the non-neoplastic Barrett's mucosa around the adenocarcinoma. MUC2 was detected in 86.7% of proximal non-neoplastic mucosa and 100% of distal non-neoplastic mucosa, while CD10 was found in 20.0% of proximal non-neoplastic mucosa and 40.0% of distal non-neoplastic mucosa of Barrett's adenocarcinoma. In conclusion, Barrett's esophageal mucosa with intestinal metaplasia and a high Ki-67 LI is suggested to be more important as a premalignant lesion, and predominantly found in the proximal rather than distal region of Barrett's esophagus.
巴雷特食管是一种与胃食管反流病相关的癌前病变，由具有化生柱状上皮（特殊柱状上皮）的黏膜组成。在本研究中，我们检测了15例食管巴雷特腺癌中黏蛋白的表达及Ki-67标记指数（LI），并阐明了巴雷特黏膜不完全肠化生作为癌前病变的意义。93.3%的腺癌中检测到胃黏蛋白（MUC5AC、HGM和/或MUC6），而MUC2和CD10（肠表型标志物）的检测率分别为73.3%和46.2%。巴雷特腺癌中的Ki-67 LI为34.1%。在所有病例中，腺癌周围的非肿瘤性巴雷特黏膜中均发现胃黏蛋白。MUC2在巴雷特腺癌近端非肿瘤性黏膜中的检测率为86.7%，在远端非肿瘤性黏膜中的检测率为100%，而CD10在近端非肿瘤性黏膜中的检测率为20.0%，在远端非肿瘤性黏膜中的检测率为40.0%。总之，具有肠化生且Ki-67 LI高的巴雷特食管黏膜作为癌前病变可能更为重要，且主要见于巴雷特食管的近端而非远端区域。
