摘要
目的观察α-甲基酰基-辅酶A消旋酶(AMACR/P504S)在胃内镜黏膜下剥离术(ESD)切除标本中非肿瘤胃黏膜-癌前病变-早期胃癌中的表达情况,探讨其在胃早期癌发生、发展过程中的意义。方法选取2015年1月至2019年12月南京大学附属鼓楼医院病理科收集的187例胃黏膜胃内镜黏膜下剥离术(ESD)切除标本作为研究对象,根据世界卫生组织(WHO)分类原则分为无异型增生组(n=20),低级别上皮内瘤变组(n=27),高级别上皮内瘤变组(n=22),腺癌组(n=118)。检测4组胃黏膜中AMACR/P504S的表达。结果无异型增生组胃黏膜中,AMACR/P504S仅1例病例中阳性表达,阳性率为5.00%,着色主要位于腺体隐窝颈-底部。在低级别上皮内瘤变病例中AMACR/P504S阳性率为48.15%,但阳性表达强度偏弱。高级别上皮内瘤变和胃腺癌中阳性率分别为86.36%和82.20%,AMACR/P504S在高级别上皮内瘤变中的表达明显高于低级别上皮内瘤变,差异有统计学意义(P<0.05),与胃早期腺癌比较差异无统计学意义。结论AMACR/P504S可作为胃黏膜高级别病变(包括高级别上皮内瘤变和早期癌)与低级别上皮内瘤变鉴别诊断的免疫标记物。
Objective To observe the expression ofα-methylacyl-CoA racemase(AMACR/P504S)in non-tumor gastric mucosa-precancerous lesions-early gastric cancer in gastric endoscopic submucosal dissection(ESD)resection specimens,and to explore its significance in the occurrence and development of gastric cancer.Methods Atotal of 187 cases of endoscopic submucosal dissection(ESD)resection specimens collected by the Department of Pathology of Drum Tower Hospital Affiliated to Nanjing University from January 2015 to December 2019 were selected as the research subjects,which were divided into the without dysplasia group(n=20),the low-grade intraepithelial neoplasia group(n=27),the high-grade intraepithelial neoplasia group(n=22),and adenocarcinoma group(n=118).The expression of AMACR/P504S in four groups were detected.Results Among the 20 patients without dysplasia,AMACR/P504S was positively expressed in only 1 case,with a positive rate of 5.00%,and the coloration was mainly located in the neck-bottom of the crypt.In low-grade cases of intraepithelial neoplasia,the positive rate of AMACR/P504S was 48.15%,but the positive expression intensity was weak.The positive rates of high-grade intraepithelial neoplasia and gastric adenocarcinoma were 86.36%and 82.20%,respectively,and the expression of AMACR/P504S in high-grade intraepithelial neoplasia was significantly higher than that in low-grade intraepithelial neoplasia,and the difference was statistically significant(P<0.05),and there was no significant difference compared with early gastric adenocarcinoma.Conclusion AMACR/P504S can be used as an immunomarker for the differential diagnosis of high-grade gastric mucosal lesions,including high-grade intraepithelial neoplasia and early cancer,and low-grade intraepithelial neoplasia.
作者
刘福兴
陈南南
孙琦
LIU Fuxing;CHEN Nannan;SUN Qi(Department of Pathology,Taizhou People's Hospital,Taizhou,Jiangsu,225300,China;Department of Pathology,Second Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210011,China;Department of Pathology,Drum Tower Hospital,Nanjing University,Nanjing,Jiangsu,210008,China)
出处
《当代医学》
2022年第30期145-149,共5页
Contemporary Medicine
基金
2019年希思科-豪森肿瘤研究基金(Y-HS2019/2-039)。
