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目的寻找筛查食管鳞状上皮细胞癌前病变的方法,为食管癌的早期诊断提供依据。方法在河南省林州市食管癌高发区,使用食管镜和Lugol氏碘液染色检查对725人进行筛查研究。所有研究对象,取组织活检,并收集血样。按食管镜病理组织学结果分为正常、食管炎、不典型增生、早期癌,随机抽取84例作为研究对象,用ELISA方法检测血清中部分肿瘤分子标记物的浓度,包括:金属基质蛋白(MMP9);组织抑制因子(TIMP1);Cu/Zn过氧化物歧化酶(Cu/ZnSOD);抗p53自身抗体(Antip53autoantibody)和可溶血清白细胞2受体(IL2sRα)。结果正常和食管炎组MMP9浓度中位数为150ng/ml,四分位距为(80～225)ng/ml;不典型增生和早期癌组中位数为97ng/ml,四分位距为(58～155)ng/ml;两组间浓度差异有统计学意义(P=0.033)。其他4种血清标志物在两组间差异无统计学意义。结论MMP9检测对食管鳞状上皮不典型增生筛查有一定意义,但需要进一步研究。
Objective To search for the method of screening esophageal squamous cell precancerous lesions and provide the basis for the early diagnosis of esophageal cancer. Methods A total of 725 people were screened by esophagoscopy and Lugol’s iodine staining in the high incidence area of esophageal cancer in Linzhou City, Henan Province. All subjects, taking tissue biopsies, and collecting blood samples. Esophageal histopathological findings were divided into normal, esophagitis, atypical hyperplasia, early cancer, 84 patients were randomly selected as the study object, serum concentrations of some tumor markers were detected by ELISA, including: matrix metalloproteinum (MMP9 ); Tissue inhibitor of metalloproteinase (TIMP1); Cu / Zn superoxide dismutase (Cu / ZnSOD); anti-p53 autoantibody and soluble serum leukocyte 2 receptor (IL2sRα). Results The median MMP9 concentration in normal and esophagitis group was 150 ng / ml and the interquartile range was (80 ~ 225) ng / ml. The median of atypical hyperplasia and early cancer group was 97 ng / ml. The interquartile range was (58 ~ 155) ng / ml; the difference between the two groups was statistically significant (P = 0.033). The other four serum markers in the two groups showed no significant difference. Conclusion MMP9 detection of esophageal squamous dysplasia screening has some significance, but needs further study.