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目的 :探讨高、低发区人群贲门癌变过程中表皮生长因子受体 (EGFR)表达与病变发生发展的生物学意义。方法 :采用免疫组织化学方法 (ABC法 ) ,检测高 (133例 )、低发区 (14 2例 )居民贲门上皮不同程度病变的EGFR变化特征及其与病变的关系。结果 :在贲门癌高发区 ,随贲门上皮病变进展 ,慢性浅表性胃炎 (CSG)→慢性萎缩性胃炎 (CAG)→不典型增生 (DYS)→贲门腺癌 (GCA) ,EGFR蛋白阳性率分别为 4 3%、4 4 %、79%和 5 3% ;DYS组EGFR蛋白阳性率与其它各组比较差异有统计学意义 (P值均 <0 .0 5 ) ;EGFR蛋白表达阳性率随贲门癌分化程度降低而减低 ,但无统计学意义。在贲门癌低发区 ,随贲门上皮病变加重 ,EGFR蛋白阳性率呈明显上升趋势 ,从CSG→CAG→DYS→GCA ,EGFR蛋白阳性率分别为 16 %、2 7%、5 0 %和 4 6 % ;正常贲门组织 (NOR)、CSG与GCA ,NOR、CSG与DYS比较差异均有统计学意义 (P值均 <0 .0 5 )。EGFR蛋白表达阳性率不随贲门癌分化程度降低而改变。结论 :EGFR是贲门上皮癌变 ,特别是早期病变的重要分子变化。高、低发区贲门癌变可能存在不同的分子基础 ,环境中暴露的致癌因素不同 (质和量 )可能是导致这种差异的主要原因
Objective: To investigate the biological significance of epidermal growth factor receptor (EGFR) expression and pathological changes in gastric cardia in high and low incidence areas. Methods: Immunohistochemical method (ABC method) was used to detect the changes of EGFR and the relationship between the changes of EGFR and the pathological changes of the cardia epithelium in high and low incidence areas (142 cases). Results: The positive rate of EGFR protein in patients with high incidence of cardia cancer was higher with the progression of cardia epithelial lesions than those with chronic superficial gastritis (CSG) → chronic atrophic gastritis (CAG) → dysplasia (DYS) → gastric cardia adenocarcinoma (GCA) (P <0.05). The positive rate of EGFR protein in DYS group was significantly different from other groups (P <0.05) The degree of cancer differentiation decreased and decreased, but not statistically significant. In the low incidence area of cardia cancer, the positive rates of EGFR protein increased with the increase of cardia epithelial lesions. The positive rates of EGFR protein were 16%, 27%, 50% and 46% respectively from CSG → CAG → DYS → GCA %. There was significant difference in normal cardia (NOR), CSG and GCA, NOR, CSG and DYS (all P <0.05). The positive rate of EGFR protein expression did not change with the differentiation of cardia carcinoma. Conclusion: EGFR is a key molecular change in carcinogenesis of cardia epithelium, especially early lesions. High and low incidence of gastric cardia may exist different molecular basis of exposure to different environmental carcinogens (quality and quantity) may be the main reason for this difference