摘要
目的探讨胃高级别上皮内瘤变组织微细结构形态与Ki-67表达水平的关系。方法应用OlympusGIF-HQ290型放大内镜对63例患者的胃黏膜可疑病变进行观察,利用其内镜窄带成像术(NBI)联合放大功能观察病灶部位胃小凹形态和微血管的改变,并取材送病理组织学检查,行常规HE染色及免疫组化Ki-67染色。统计分析相关病理参数与不同类型微细结构的关联性。结果Ki-67在胃正常黏膜、低级别上皮内瘤变、高级别上皮内瘤变的阳性表达呈明显递增关系,随着病变加重,阳性表达范围逐渐增大。低级别上皮内瘤变病灶中,以E型胃小凹开口及I型微血管改变为主,且Ki-67表达多为阴性;而在高级别上皮内瘤变病灶中,以F型胃小凹开口及D型微血管改变为主,且Ki-67表达多为阳性,各型间差异均具有统计学意义(P<0.05)。结论NBI放大内镜能够清晰显示胃黏膜病变轮廓,可清晰观察到胃小凹及微血管形态,能有效提高早期胃癌及异性增生检查的准确性。Ki-67表达与胃癌的发生、发展密切相关,参与胃癌发生的早期过程,检测该分子标记物有助于判断病变的严重程度及进展趋势,有利于提高胃的癌前病变和早期胃癌的检出率。
Objective To investigate the correlation between microstructure and Ki-67 expression of gastric high-grade intraepithelial neoplasia. Methods The suspected gastric mucosal lesions of 63 patients were observed by Olympus GIF-HQ290 magnifying endoscopy. The morphology of gastric pits and microvessel changes in location of lesion were observed by NBI combined with enlargement function. Samples were sent for histopathological examination by routine HE staining and immunohistochemical Ki-67 staining. The correlation between pathological parameters and different types of microstructures was analyzed. Results The positive expression of Ki-67 in normal gastric mucosa, low-grade intraepithelial neoplasia and high-grade intraepithelial neoplasia increased significantly. With the aggravation of the lesion, the positive expression range enlarged gradually. In low-grade intraepithelial neoplasia, E-type stomach pit opening and I-type microvessel changes were dominant, and the expression of Ki-67 was mostly negative, while in high-grade intraepithelial neoplasia, F-type stomach pit opening and D-type microvessel changes were dominant, and Ki-67 expression was mostly positive, with significant differences among different types (P<0.05). Conclusion NBI magnifying endoscopy can clearly show the outline of gastric mucosal lesions, and can clearly observe the morphology of gastric pits and microvessels. It can effectively improve the accuracy of early gastric cancer and heterosexual hyperplasia examination. The expression of Ki-67 is closely related to the occurrence and development of gastric cancer, and participates in the early process of gastric cancer, detection of the molecular marker is helpful to judge the severity and progression trend of gastric cancer, and to improve the detection rate of precancerous lesions and early gastric cancer.
作者
彭晓峰
温祥
袁士成
周文泉
陈丽萍
曾书君
陈惠新
余志金
PENG Xiao-feng;WEN Xiang;YUAN Shi-cheng;ZHOU Wen-quan;CHEN Li-ping;ZENG Shu-jun;CHEN Hui-xin;YU Zhi-jin(Pathology Department, the First People's Hospital of Huizhou City, Huizhou 516003;Gastroenterology Department,the Central People's Hospital of Huizhou City, Huizhou 516001, China)
出处
《临床医学研究与实践》
2019年第19期11-13,共3页
Clinical Research and Practice
基金
惠州市科技计划项目(No.2015Y003,No.2017Y025,No.2018Y058)
关键词
放大内镜
早期胃癌
免疫组织化学
magnifying endoscopy
early gastric cancer
immunohistochemistry
