P物质在BARRETT食管黏膜组织中表达.docVIP

P物质在BARRETT食管黏膜组织中的表达 　　作者：王淑平,卫红军,王青,张巍巍　　作者单位：青岛大学医学院附属青岛市市立医院 　　【摘要】 目的研究P物质在BARRETT食管(BE)黏膜组织中的表达，探讨其在BE发病中的作用。方法应用免疫组织化学方法测定P物质在正常对照组(n=25)及BE组(n=58)中的表达，并比较P物质在不同化生程度、伴或不伴胆汁反流BE组中表达的差异。结果 P物质在BE中的表达低于对照组，且胃化生(+)BE组P物质表达高于肠化生(+)BE组，差异均有显著性(t=9.98、3.25,P0.05);伴胆汁反流BE组P物质表达明显低于不伴胆汁反流BE组(t=3.04,P0.05)，而伴胆汁反流BE组肠化生阳性率高于不伴胆汁反流BE组，差异有显著性(Χ2=4.99,P0.05)。结论 BE组存在P物质分泌失调，其可能在BE的发生发展中起着一定作用;胆汁反流可能影响BE黏膜P物质的分泌，而与肠化生的发生可能有关。 　　【关键词】 BARRETT食管,P物质,免疫组织化学 　　[ABSTRACT] Objective To study the expression of substance P (SP) in mucosa of Barrett esophagus (BE) and its role on pathogenesis of BE. Methods Immunohistochemistry technique was applied to detect the expressions of SP in mucosa of normal esophagus and BE, and compare the differences of SP expression in different extents of metaplasia in BE with or without bile reflux. Results Expression of SP in mucosa of BE was significantly lower than that of the normal esophagus, and its expression in mucosa of the BE with gastric metaplasia was significantly higher than that with intestinal metaplasia (t=9.98,3.25;P0.05); moreover, expression of SP in mucosa of BE with bile reflux was lower than that of BE without reflux (t=3.04,P0.05). Positive rate of intestinal metaplasia found in BE with bile reflux was significantly higher than that BE without reflux (Χ2=4.99,P0.05). Conclusion Dyssecretosis of SP exists in BE, which, probably, plays a certain effect on the occurrence and development of BE. The bile regurgitation may influence the secretion of SP in mucosa, which is likely to be involved in the intestinal metaplasia. 　　[KEY WORDS] barrett esophagus; substance P; immunohistochemistry 　　BARRETT食管(BE)由BARRETT于1950年提出。近年来,BE及其相关食管腺癌的发生率明显提高, 西方国家尤其明显, 在有反流症状的病人中BE的发生率可达15%, 每年大约有1% 的BE病人发展为食管腺癌[1]。P物质(SP)为脑肠肽，它可调节食管下括约肌压力(LESP)，与胃食管反流的发生相关。本研究采用免疫组织化学方法研究BE黏膜组织中P物质的表达，以探讨P物质在BE发病中的作用。现将结果报告如下。 　　1 资料与方法 　　1.1 一般资料 　　所有研究对象均选自2007年1月mdash;2009年8月我院消化内科及胃镜室的受检查，其中BE组58例，正常对照组25例。BE组，男31例，女27例，年龄20～82岁，